Effect of machine learning-guided haemodynamic optimization on postoperative free flap perfusion in reconstructive...

Area of Science:

• Anesthesiology
• Surgical Oncology
• Biomedical Engineering

Background:

• Intraoperative hypotension and excessive fluid administration are linked to complications in maxillofacial free flap surgery.
• The hypotension prediction index (HPI) shows promise in predicting and managing hypotension using arterial pressure waveform analysis.
• Previous studies indicate HPI-guided protocols can decrease hypotension duration and severity.

Purpose of the Study:

• To evaluate if HPI-guided hemodynamic therapy improves postoperative flap perfusion and tissue oxygenation.
• To determine if HPI therapy enhances intraoperative mean arterial pressure and reduces fluid infusion in maxillofacial free flap surgery.

Main Methods:

• A single-center, randomized controlled trial involving 42 maxillofacial free flap surgery patients.
• Patients will be randomized into an intervention group (HPI-guided hemodynamic optimization via HemoSphere platform) or a control group.
• Postoperative flap tissue oxygen saturation will be monitored noninvasively using near-infrared spectroscopy for 24 hours.

Main Results:

• Primary outcome is the average tissue oxygen saturation in the first 24 postoperative hours.
• Secondary outcomes will likely include intraoperative mean arterial pressure and fluid infusion volumes.
• Analysis will compare outcomes between the HPI-guided intervention group and the control group.

Conclusions:

• This study protocol aims to establish the efficacy of HPI-guided hemodynamic therapy in improving surgical outcomes.
• Findings could lead to optimized perioperative management strategies for free flap surgeries.
• Successful implementation may reduce postoperative complications and enhance flap viability.