Closed-loop vasopressor systems for hemodynamic control in perioperative and critical care settings: a systematic review and meta-analysis.
Jorge Iván Alvarado-Sánchez, Diana María Abril-Calderón, Isabella Sánchez-Quimbayo et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness of closed-loop vasopressor (CLV) systems compared to manual titration in adults undergoing surgery or in intensive care. The analysis included six randomized controlled trials with 215 patients. CLV systems significantly increased time within the mean arterial pressure (MAP) target range by 33.94% and reduced time in hypotension by 18.24%.
Key findings
- CLV systems increased time within the MAP target range by 33.94%.
- CLV systems reduced time in hypotension by 18.24%.
- No significant difference was found in time in hypertension or cumulative norepinephrine dose.
Why it matters
The findings suggest that closed-loop vasopressor systems may enhance hemodynamic management in surgical and critically ill patients, potentially leading to better outcomes. However, the evidence is limited and further research is necessary.
What to keep in mind
Heterogeneity among studies and small sample sizes limit the confidence in the effect size and generalizability of the results.