低血压预测指数智能警报和趋势,以改善对目标导向的血液动力学治疗的遵守:可行性研究
Carlos E Guerra-Londono1, William R Hand2, Neal Fleming3
1Department of Anesthesiology, Pain Management, & Perioperative Medicine, Henry Ford Health, 2799 W Grand Boulevard, 4th Floor, Detroit, MI, 48323, USA. cguerra1@hfhs.org.
BMC anesthesiology
|October 1, 2025
概括
低血压预测指数 (HPI) 智能警报在非心脏手术期间改善了对目标导向血液动力学治疗 (GDHT) 的遵守. 这项技术在降低手术内低血压和改善患者的治疗结果方面表现有前途.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 医疗技术 医疗技术 医学技术
背景情况:
- 目标导向的血液动力学治疗 (GDHT) 对术后结果至关重要,但往往由于算法遵守不佳而受到限制.
- 低血压预测指数 (HPI) 技术和带有智能警报的Acumen HPI软件旨在通过识别低血压机制来提高GDHT合规性.
- 这项研究调查了HPI智能警报在改善遵守GDHT协议方面的有效性.
研究的目的:
- 评估Acumen HPI智能警报是否可以在中度至高风险的选择性非心脏手术中改善对GDHT算法的遵守.
- 评估在临床环境中实施HPI引导的GDHT的可行性.
- 确定HPI智能警报对手术内低血压管理的影响.
主要方法:
- 一个多中心,混合方法,单臂可行性试验,涉及接受中高风险非心脏手术的成年人.
- 使用HPI引导的GDHT,具有可操作的趋势和自动智能预警通知,表明可能的低血压机制.
- 衡量的主要结果是HPI通知导致及时,算法一致的干预的比例.
主要成果:
- 共有122名受试者被录取,在各中心均有均衡的参与.
- 总体遵守GDHT算法的比例为77.1% (95% CI:74.5-79.6%).
- 观察到65mmHg以下的手术内低血压的低中位数分钟 (2.9分钟).
结论:
- 在高风险非心脏手术患者中,HPI智能警报显示了提高手术内GDHT算法合规性的潜力.
- 观察到低血压的低发病率表明,可能会减少相关的不良事件.
- 建议进行进一步的大规模随机试验,以证实这些发现.
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