Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial

Karim Kouz; Mirja Wegge; Moritz Flick; Alina Bergholz; Parisa Moll-Khosrawi; Rainer Nitzschke; Constantin J C Trepte; Linda Krause; Daniel I Sessler; Christian Zöllner; Bernd Saugel

doi:10.1016/j.bja.2022.06.027

Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial

Standard

Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial. / Kouz, Karim ; Wegge, Mirja ; Flick, Moritz ; Bergholz, Alina ; Moll-Khosrawi, Parisa ; Nitzschke, Rainer ; Trepte, Constantin J C ; Krause, Linda; Sessler, Daniel I; Zöllner, Christian ; Saugel, Bernd.

In: BRIT J ANAESTH, Vol. 129, No. 4, 10.2022, p. 478-486.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Kouz, K , Wegge, M , Flick, M , Bergholz, A , Moll-Khosrawi, P , Nitzschke, R , Trepte, CJC , Krause, L, Sessler, DI, Zöllner, C & Saugel, B 2022, 'Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial', BRIT J ANAESTH, vol. 129, no. 4, pp. 478-486. https://doi.org/10.1016/j.bja.2022.06.027

APA

Kouz, K., Wegge, M., Flick, M., Bergholz, A., Moll-Khosrawi, P., Nitzschke, R., Trepte, C. J. C., Krause, L., Sessler, D. I., Zöllner, C., & Saugel, B. (2022). Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial. BRIT J ANAESTH, 129(4), 478-486. https://doi.org/10.1016/j.bja.2022.06.027

Vancouver

Kouz K , Wegge M , Flick M , Bergholz A , Moll-Khosrawi P , Nitzschke R et al. Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial. BRIT J ANAESTH. 2022 Oct;129(4):478-486. https://doi.org/10.1016/j.bja.2022.06.027

Bibtex

@article{98c3f42bf96b4849b593dc05c94b4bb7,

title = "Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial",

abstract = "BACKGROUND: Hypotension during induction of anaesthesia is associated with organ injury. Continuous arterial pressure monitoring might help reduce hypotension. We tested the hypothesis that continuous intra-arterial compared with intermittent oscillometric arterial pressure monitoring reduces hypotension during induction of anaesthesia in noncardiac surgery patients.METHODS: In this single-centre randomised trial, 242 noncardiac surgery patients in whom intra-arterial arterial pressure monitoring was planned were randomised to unblinded continuous intra-arterial or to intermittent oscillometric arterial pressure monitoring (with blinded intra-arterial arterial pressure monitoring) during induction of anaesthesia. The primary endpoint was the area under a mean arterial pressure (MAP) of 65 mm Hg within the first 15 min of induction of anaesthesia. Secondary endpoints included areas under MAP values of 60, 50, and 40 mm Hg and durations of MAP values <65, <60, <50, and <40 mm Hg.RESULTS: There were 224 subjects available for analysis. The median (25th-75th percentile) area under a MAP of 65 mm Hg was 15 (2-36) mm Hg • min in subjects assigned to continuous intra-arterial monitoring and 46 (7-111) mm Hg • min in subjects assigned to intermittent oscillometric monitoring (P<0.001). Subjects assigned to continuous intra-arterial monitoring had smaller areas under MAP values of 60, 50, and 40 mm Hg and shorter durations of MAP values <65, <60, <50, and <40 mm Hg than subjects assigned to intermittent oscillometric monitoring.CONCLUSION: Continuous intra-arterial arterial pressure monitoring reduces hypotension during induction of anaesthesia compared with intermittent oscillometric arterial pressure monitoring in noncardiac surgery patients. In patients for whom an arterial catheter is planned, clinicians might therefore consider inserting the arterial catheter before rather than after induction of anaesthesia.CLINICAL TRIALS REGISTRATION: NCT04894019.",

author = "Karim Kouz and Mirja Wegge and Moritz Flick and Alina Bergholz and Parisa Moll-Khosrawi and Rainer Nitzschke and Trepte, {Constantin J C} and Linda Krause and Sessler, {Daniel I} and Christian Z{\"o}llner and Bernd Saugel",

year = "2022",

month = oct,

doi = "10.1016/j.bja.2022.06.027",

language = "English",

volume = "129",

pages = "478--486",

journal = "BRIT J ANAESTH",

issn = "0007-0912",

publisher = "Oxford University Press",

number = "4",

}

RIS

TY - JOUR

T1 - Continuous intra-arterial versus intermittent oscillometric arterial pressure monitoring and hypotension during induction of anaesthesia: the AWAKE randomised trial

AU - Kouz, Karim

AU - Wegge, Mirja

AU - Flick, Moritz

AU - Bergholz, Alina

AU - Moll-Khosrawi, Parisa

AU - Nitzschke, Rainer

AU - Trepte, Constantin J C

AU - Krause, Linda

AU - Sessler, Daniel I

AU - Zöllner, Christian

AU - Saugel, Bernd

PY - 2022/10

Y1 - 2022/10

N2 - BACKGROUND: Hypotension during induction of anaesthesia is associated with organ injury. Continuous arterial pressure monitoring might help reduce hypotension. We tested the hypothesis that continuous intra-arterial compared with intermittent oscillometric arterial pressure monitoring reduces hypotension during induction of anaesthesia in noncardiac surgery patients.METHODS: In this single-centre randomised trial, 242 noncardiac surgery patients in whom intra-arterial arterial pressure monitoring was planned were randomised to unblinded continuous intra-arterial or to intermittent oscillometric arterial pressure monitoring (with blinded intra-arterial arterial pressure monitoring) during induction of anaesthesia. The primary endpoint was the area under a mean arterial pressure (MAP) of 65 mm Hg within the first 15 min of induction of anaesthesia. Secondary endpoints included areas under MAP values of 60, 50, and 40 mm Hg and durations of MAP values <65, <60, <50, and <40 mm Hg.RESULTS: There were 224 subjects available for analysis. The median (25th-75th percentile) area under a MAP of 65 mm Hg was 15 (2-36) mm Hg • min in subjects assigned to continuous intra-arterial monitoring and 46 (7-111) mm Hg • min in subjects assigned to intermittent oscillometric monitoring (P<0.001). Subjects assigned to continuous intra-arterial monitoring had smaller areas under MAP values of 60, 50, and 40 mm Hg and shorter durations of MAP values <65, <60, <50, and <40 mm Hg than subjects assigned to intermittent oscillometric monitoring.CONCLUSION: Continuous intra-arterial arterial pressure monitoring reduces hypotension during induction of anaesthesia compared with intermittent oscillometric arterial pressure monitoring in noncardiac surgery patients. In patients for whom an arterial catheter is planned, clinicians might therefore consider inserting the arterial catheter before rather than after induction of anaesthesia.CLINICAL TRIALS REGISTRATION: NCT04894019.

AB - BACKGROUND: Hypotension during induction of anaesthesia is associated with organ injury. Continuous arterial pressure monitoring might help reduce hypotension. We tested the hypothesis that continuous intra-arterial compared with intermittent oscillometric arterial pressure monitoring reduces hypotension during induction of anaesthesia in noncardiac surgery patients.METHODS: In this single-centre randomised trial, 242 noncardiac surgery patients in whom intra-arterial arterial pressure monitoring was planned were randomised to unblinded continuous intra-arterial or to intermittent oscillometric arterial pressure monitoring (with blinded intra-arterial arterial pressure monitoring) during induction of anaesthesia. The primary endpoint was the area under a mean arterial pressure (MAP) of 65 mm Hg within the first 15 min of induction of anaesthesia. Secondary endpoints included areas under MAP values of 60, 50, and 40 mm Hg and durations of MAP values <65, <60, <50, and <40 mm Hg.RESULTS: There were 224 subjects available for analysis. The median (25th-75th percentile) area under a MAP of 65 mm Hg was 15 (2-36) mm Hg • min in subjects assigned to continuous intra-arterial monitoring and 46 (7-111) mm Hg • min in subjects assigned to intermittent oscillometric monitoring (P<0.001). Subjects assigned to continuous intra-arterial monitoring had smaller areas under MAP values of 60, 50, and 40 mm Hg and shorter durations of MAP values <65, <60, <50, and <40 mm Hg than subjects assigned to intermittent oscillometric monitoring.CONCLUSION: Continuous intra-arterial arterial pressure monitoring reduces hypotension during induction of anaesthesia compared with intermittent oscillometric arterial pressure monitoring in noncardiac surgery patients. In patients for whom an arterial catheter is planned, clinicians might therefore consider inserting the arterial catheter before rather than after induction of anaesthesia.CLINICAL TRIALS REGISTRATION: NCT04894019.

U2 - 10.1016/j.bja.2022.06.027

DO - 10.1016/j.bja.2022.06.027

M3 - SCORING: Journal article

C2 - 36008202

VL - 129

SP - 478

EP - 486

JO - BRIT J ANAESTH

JF - BRIT J ANAESTH

SN - 0007-0912

IS - 4

ER -