Hypotension Prediction Index based protocolized haemodynamic management reduces the incidence and duration of intraopera
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ORIGINAL RESEARCH
Hypotension Prediction Index based protocolized haemodynamic management reduces the incidence and duration of intraoperative hypotension in primary total hip arthroplasty: a single centre feasibility randomised blinded prospective interventional trial Emmanuel Schneck1 · Dagmar Schulte1 · Lukas Habig1 · Sophie Ruhrmann1 · Fabian Edinger1 · Melanie Markmann1 · Marit Habicher1 · Markus Rickert2 · Christian Koch1 · Michael Sander1 Received: 15 August 2019 / Accepted: 26 November 2019 © Springer Nature B.V. 2019
Abstract The “Hypotension Prediction Index (HPI)” represents a newly introduced monitoring-tool that aims to predict episodes of intraoperative hypotension (IOH) before their occurrence. In order to evaluate the feasibility of protocolized care according to HPI monitoring, we hypothesized that HPI predicts the incidence of IOH and reduces the incidence and duration of IOH. This single centre feasibility randomised blinded prospective interventional trial included at total of 99 patients. One group was managed by goal-directed therapy algorithm based on HPI (HPI, n = 25), which was compared to a routine anaesthetic care cohort (CTRL, n = 24) and a third historic control group (hCTRL, n = 50). Primary endpoints included frequency (n)/h, absolute and relative duration (t (min)/% of total anaesthesia time) of IOH. Significant reduction of intraoperative hypotension was recorded in the HPI group compared to the control groups (HPI 48%, CTRL 87.5%, hCTRL 80%; HPI vs. CTRL, respectively hCTRL p
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