Software di supporto decisionale su base predittiva, primo del suo genere, che rileva la probabilità di un evento ipotensivo^ prima che si verifichi.3,4
Numerosi studi mostrano che l'IOH è fortemente associata al rischio, in particolare al rischio di danno miocardico, danno renale acuto e mortalità.5-12 Di conseguenza la gestione dell'IOH, rischio potenzialmente evitabile, è fondamentale.5
Il software Acumen Hypotension Prediction Index (HPI) riporta una gamma di parametri emodinamici di pressione e flusso sanguigno che offrono informazioni continue sulla potenziale IOH ed emette un avviso quando il paziente tende a un evento ipotensivo^. Basato su un algoritmo proprietario sviluppato con l'apprendimento automatico attraverso i dati di >59.000 eventi ipotensivi e >144.000 eventi non ipotensivi, il software Acumen HPI consente di adottare tempestivamente la linea d'azione migliore e potenzialmente evitare l'IOH e i rischi associati.13-15
- Hatib F et al, Machine-learning Algorithm to Predict Hypotension Based on High-fidelity Arterial Pressure Waveform Analysis Anesthesiology 2018, Vol.129, 663-674.
- Davies SJ, Vistisen ST, Jian Z, Hatib F, Scheeren TWL. Ability of an Arterial Waveform Analysis Derived Hypotension Prediction Index to Predict Future Hypotensive Events in Surgical Patients. Anesth Analg. 2020 Feb;130(2):352-359.
- Ward H. van der Ven, Denise P. Veelo, Marije Wijnberge, Björn J.P. van der Ster, Alexander P.J. Vlaar, Bart F. Geerts, One of the first validations of an artificial intelligence algorithm for clinical use: The impact on intraoperative hypotension prediction and clinical decision-making, Surgery, Volume 169, Issue 6, 2021, Pages 1300-1303, ISSN 0039-6060, https://doi.org/10.1016/j.surg.2020.09.041.
- Feras Hatib, Zhongping Jian, Sai Buddi, Christine Lee, Jos Settels, Karen Sibert, Joseph Rinehart,Maxime Cannesson; Machine-learning Algorithm to Predict Hypotension Based on High fidelity Arterial Pressure Waveform Analysis. Anesthesiology 2018; 129:663-674.
- Gregory A, Stapelfeldt WH, Khanna AK, et al. Intraoperative hypotension is associated with adverse clinical outcomes after noncardiac surgery. Anesth Analg. 2021;132(6):1654-1665.
- Wesselink EM, Kappen TH, Torn HM, et al. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth. 2018;121(4):706-721.
- Monk TG, et al. Anesthetic Management and One-Year Mortality After Noncardiac Surgery. Anesth Analg 2005;100:4-10.
- Monk TG, et al. Association between Intraoperative Hypotension and Hypertension and 30- day Postoperative Mortality in Noncardiac Surgery. Anesthesiology 2015; 123:307-19.
- Walsh M, et al. Relationship between Intraoperative Mean Arterial Pressure and Clinical Outcomes after Noncardiac Surgery Toward an Empirical Definition of Hypotension Anesthesiology, 2013;119(3):507-515.
- Sun LY, et al. Association of Intraoperative Hypotension with Acute Kidney Injury after Elective Noncardiac Surgery. Anesthesiology 2015;123:515-23.
- Hirsch J, et al. Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after noncardiac surgery. British Journal of Anaesthesia, 2015:418-26.
- Bijker JB, et al. Intraoperative Hypotension and Perioperative Ischemic Stroke after General Surgery: A Nested Casecontrol Study. Anesthesiology, 2012;116: 658-664.
- Pinsky MR. Chapter 5: Overview of the circulation. In: Cannesson M, Pearse R, eds. Perioperative hemodynamic monitoring and goal directed therapy: from theory to practice. 2nd ed. Cambridge University Press;2015:29-38.
- Schneck E, Schulte D, Habig L, et al. 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. J Clin Monit Comput. 2020;34(6):1149-1158.
- Wijnberge M, Geerts BF, Hol L, et al. Effect of a machine learning-derived early warning system for intraoperative hypotension vs standard care on depth and duration of intraoperative hypotension during elective noncardiac surgery.
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