University of Pittsburgh and Carnegie Mellon University researchers have developed a novel approach to reducing the risk of intraoperative hypotension (IOH). The approach defines hemodynamic parameters that clinicians should aim to maintain during surgery, and which are based on the risk factors of the individual and the surgical procedure.
Description
IOH, low blood pressure during surgery, causes complications in over 70 million surgeries annually in the US alone. Severe complications can include heart, kidney, and brain damage. Effective prevention strategies present an unmet need and the development of such would empower clinicians to reduce the incidence of IOH improving quality of care, lowering costs of surgery, and improving outcomes for patients.
Applications
1. Intraoperative hypotension
2. Reduction of post-surgical complications
Advantages
Currently no strategies exist to prevent IOH, only to limit the consequences through rapid recognition and treatment.
To prevent IOH, this novel approach uses a patient’s medical history to predict personalized hemodynamic targets to be maintained during surgery. This strategy reduces the risk of IOH addressing a major gap in perioperative care planning and harm reduction. Additionally, this personalized risk calculator can easily be integrated into hospital information systems allowing ease of determination of IOH risk and associated hemodynamics as a perioperative step, removing the need for it to be considered in the operating room.
Invention Readiness
Using data from over 100 000 non-cardiac surgeries the relationship between mean arterial pressure (MAP) and IOH within five minutes was determined and validated against data from a further 45 000 surgeries. Factors including age, gender, ASA Physical Status classification, and whether surgery was emergency or not, could all be used to determine MAP levels below which the risk of IOH grew exponentially. This algorithm can be used to determine the optimal MAP that should be maintained during surgery and highlights to surgical teams the risk of imminent IOH allowing for early intervention to prevent IOH.
A web app integrated into hospital patient record systems is currently in use at University of Pittsburgh Medical Center (UPMC) to generate targets in real-time which are undergoing clinical testing as part of the validation process.
IP Status
https://patents.google.com/patent/WO2023014655A1
