Part of the Steamroller and Not Part of the Road: Better Blood Pressure Management Through Automation

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In a survey published >10 years ago, Lienhart et al1 found that intraoperative hypotension was one of the most frequent factors associated with death related to anesthesia. As we know, hypotension is common during the intraoperative period and has been shown to occur most predominantly during anesthesia induction.2 Cumulative hypotension in the operating room has been associated with an increased risk of stroke,3 acute kidney injury,4 myocardial injury,5–7 and overall mortality.8 Even short periods of hypotension, however, may be sufficient to increase morbidity,7,9 and 2 large studies have recently confirmed that even mild hypotension still increases the overall mortality risk in adult patients undergoing noncardiac surgery.10,11 Hypotension may be even more frequent during spinal anesthesia, occurring in up to 60% of patients12,13 undergoing cesarean deliveries, which may affect the mother (nausea, vomiting, and, in extreme cases, cardiovascular collapse) and the fetus (fetal acidosis and hypoxemia).
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