Perioperative hypotension and use of vasoactive agents in non-cardiac surgery: A scoping review.

Autor: Bækgaard ES; Department of Anaesthesiology and Intensive Care, Holbæk Hospital, Holbæk, Denmark., Madsen BK; Department of Anaesthesiology and Intensive Care, Holbæk Hospital, Holbæk, Denmark.; Department of Anaesthesiology and Intensive Care, Zealand University Hospital, Køge, Denmark., Crone V; Department of Anaesthesiology and Intensive Care, Holbæk Hospital, Holbæk, Denmark., El-Hallak H; Department of Anaesthesiology and Intensive Care, Holbæk Hospital, Holbæk, Denmark.; Department of Anaesthesiology, Copenhagen University Hospital-Gentofte, Hellerup, Denmark., Møller MH; Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark., Vester-Andersen M; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Anaesthesiology and Intensive Care, Copenhagen University Hospital-Herlev-Gentofte, Herlev, Denmark., Krag M; Department of Anaesthesiology and Intensive Care, Holbæk Hospital, Holbæk, Denmark.; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2024 Oct; Vol. 68 (9), pp. 1134-1148. Date of Electronic Publication: 2024 Jul 04.
DOI: 10.1111/aas.14485
Abstrakt: Background: Perioperative hypotension is common and associated with adverse patient outcomes. Vasoactive agents are often used to manage hypotension, but the ideal drug, dose and duration of treatment has not been established. With this scoping review, we aim to provide an overview of the current body of evidence regarding the vasoactive agents used to treat perioperative hypotension in non-cardiac surgery.
Methods: We included all studies describing the use of vasoactive agents for the treatment of perioperative hypotension in non-cardiac surgery. We excluded literature reviews, case studies, and studies on animals and healthy subjects. We posed the following research questions: (1) in which surgical populations have vasoactive agents been studied? (2) which agents have been studied? (3) what doses have been assessed? (4) what is the duration of treatment? and (5) which desirable and undesirable outcomes have been assessed?
Results: We included 124 studies representing 10 surgical specialties. Eighteen different agents were evaluated, predominantly phenylephrine, ephedrine, and noradrenaline. The agents were administered through six different routes, and numerous comparisons between agents, dosages and routes were included. Then, 88 distinct outcome measures were assessed, of which 54 were judged to be non-patient-centred.
Conclusions: We found that studies concerning vasoactive agents for the treatment of perioperative hypotension varied considerably in all aspects. Populations were heterogeneous, interventions and exposures included multiple agents compared against themselves, each other, fluids or placebo, and studies reported primarily non-patient-centred outcomes.
(© 2024 Acta Anaesthesiologica Scandinavica Foundation.)
Databáze: MEDLINE
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