Hypotension Prediction Index for Hemodynamic Optimization in Major Vascular Surgery

What this Trial Is About

Researchers are evaluating a predictive algorithm called the hypotension prediction index to optimize hemodynamic management during major vascular surgery, specifically abdominal aortic aneurysm repair. The study aims to compare this new method with standard cardiovascular parameter-based care to understand if it can better manage blood pressure during surgery. The trial is led by Fondazione Policlinico Universitario Agostino Gemelli IRCCS and uses a randomized, single-masked design. Participants are divided into two groups: the control group receives hemodynamic optimization based on standard cardiovascular parameters displayed on the Hemosphere platform, with drugs and fluids administered according to mean arterial pressure and stroke volume variation. The experimental group is managed using the hypotension prediction index to guide drug and fluid administration proactively. This study focuses on the intraoperative period during aortic surgery. During the surgery, researchers will monitor blood pressure and calculate the time-weighted average of mean arterial pressure below 65 mmHg as the primary outcome. Participants undergo continuous hemodynamic monitoring to assess the effectiveness of both approaches. The trial continues until the end of surgery, with no mention of extended follow-up periods. The total duration for participants is limited to the surgical procedure timeframe.

A PREDICTIVE ALGORITHM IN AORTIC SURGERY