Higher versus lower mean arterial pressure target management in older patients having non-cardiothoracic surgery: A prospective randomized controlled trial

Hu，An Min1,2,3; Qiu，Yan4; Zhang，Peng5; Zhao，Rui6; Li，Shu Tao7; Zhang，Yao Xian1,2,3; Zheng，Zi Hao1,2,3; Hu，Bai Long8; Yang，Ya Li9; Zhang，Zhong Jun1,2,3

2021-05-01

10.1016/j.jclinane.2020.110150

JOURNAL OF CLINICAL ANESTHESIA   影响因子和分区

0952-8180

1873-4529

Study objective: This study aimed to evaluate the effects of low versus high mean arterial pressure (MAP) levels on the incidence of postoperative delirium during non-cardiothoracic surgery in older patients. Design: Multicenter, randomized, parallel-controlled, open-label, and assessor-blinded clinical trial. Setting: University hospital. Patients: Three hundred twenty-two patients aged ≥65 with an American Society of Anesthesiologists physical status of I-II who underwent non-cardiothoracic surgery with general anaesthesia. Interventions: Participants were randomly assigned into a low-level MAP (60–70 mmHg) or high-level MAP (90–100 mmHg) group during general anaesthesia. The study was conducted from November 2016 to February 2020. Participants were older patients having non-cardiothoracic surgery. The follow-up period ranged from 1 to 7 days after surgery. The primary outcome was the incidence of postoperative delirium. Main results: In total, 322 patients were included and randomized; 298 completed in-hospital delirium assessments [median (interquartile range) age, 73 (68–77) years; 173 (58.1%) women]. Fifty-four (18.1%) patients total, including 36 (24.5%) and 18 (11.9%) in the low-level and high-level MAP groups [relative risk (RR) 0.48, 95% confidence interval (CI) 0.25 to 0.87, P = 0.02], respectively, experienced postoperative delirium. The adjusted RR was 0.34 (95% CI 0.16 to 0.70, P < 0.01) in the multiple regression analysis. High-level MAP was associated with a shorter delirium span and a higher intraoperative urine volume than low-level MAP. Conclusions: In older patients during non-cardiothoracic surgery, high-level blood pressure management might help reduce the incidence of postoperative delirium.

Elderly patients General anaesthesia Mean arterial pressure Postoperative delirium

SCI

英语

其他

National Science Foundation for Young Scientists of China[81801947]

Anesthesiology

Anesthesiology

WOS:000642454300006

ELSEVIER SCIENCE INC

CLINICAL MEDICINE

2-s2.0-85098754962

Scopus

1.Department of Anesthesiology,Shenzhen People's Hospital,Shenzhen,China
2.The Second Clinical Medical College,Jinan University,Shenzhen,China
3.First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,China
4.Department of Anesthesiology and Translational Neuroscience Center,West China Hospital,Sichuan University,Chengdu,China
5.Department of Anesthesiology,Sichuan Provincial People's Hospital,Chengdu,China
6.Department of Anesthesiology,Kunming Children's Hospital,Kunming,China
7.Department of Anesthesiology,Jinan University-affiliated Shenzhen Baoan Women's and Children's Hospital,Shenzhen,China
8.Department of Anesthesiology,Affiliated Hospital of Guizhou Medical University,Guiyang,China
9.Department of Anesthesiology,Henan Provincial People's Hospital,Zhengzhou University,Zhengzhou,China

Hu，An Min,Qiu，Yan,Zhang，Peng,et al. Higher versus lower mean arterial pressure target management in older patients having non-cardiothoracic surgery: A prospective randomized controlled trial[J]. JOURNAL OF CLINICAL ANESTHESIA,2021,69.

Hu，An Min.,Qiu，Yan.,Zhang，Peng.,Zhao，Rui.,Li，Shu Tao.,...&Zhang，Zhong Jun.(2021).Higher versus lower mean arterial pressure target management in older patients having non-cardiothoracic surgery: A prospective randomized controlled trial.JOURNAL OF CLINICAL ANESTHESIA,69.

Hu，An Min,et al."Higher versus lower mean arterial pressure target management in older patients having non-cardiothoracic surgery: A prospective randomized controlled trial".JOURNAL OF CLINICAL ANESTHESIA 69(2021).