Higher versus Routine Intraoperative Blood Pressure Targets in Noncardiac Surgery: A Systematic Review and Meta-analysis with Trial Sequential Analysis of Randomized Trials.
Katie Chiou, Sovann Vikram, Kiana Rowshan et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the impact of higher intraoperative blood pressure targets on postoperative outcomes in 15 trials involving 15,603 patients undergoing elective noncardiac surgery. The study found that higher targets did not significantly reduce acute kidney injury or myocardial injury, but were associated with a reduction in postoperative delirium (RR, 0.73; 95% CI, 0.54 to 0.98; P = 0.04).
Key findings
- Higher blood pressure targets did not reduce acute kidney injury (RR, 0.95; 95% CI, 0.85 to 1.06; P = 0.36).
- No significant effect on in-hospital or 30-day mortality was observed (RR, 1.00; 95% CI, 0.75 to 1.34; P = 1.00).
- Higher targets were associated with a significant reduction in postoperative delirium (RR, 0.73; 95% CI, 0.54 to 0.98; P = 0.04).
Why it matters
Understanding the optimal intraoperative blood pressure management can help clinicians minimize postoperative complications. While higher targets may reduce delirium, the lack of improvement in other major outcomes suggests a need for careful consideration in practice.