⚡ Quick Summary
A recent pilot study explored the use of artificial intelligence in goal-directed therapy to mitigate intraoperative hypotension during lung surgery. The findings suggest that this innovative approach significantly reduced the frequency and duration of hypotensive episodes compared to standard care.
🔍 Key Details
- 📊 Participants: 150 patients undergoing lung surgery with single lung ventilation
- ⚙️ Intervention: Goal-directed therapy based on the Hypotension Prediction Index (HPI)
- 🧪 Design: Single center, single-blinded randomized controlled trial
- 🏥 Setting: University hospital operating room
🔑 Key Takeaways
- 📉 Hypotensive episodes were significantly lower in the intervention group (0 vs. 1; p = 0.01).
- ⏳ Duration of hypotension was reduced (0 min vs. 2.33 min; p = 0.01).
- 📉 Area under MAP of 65 was significantly lower in the intervention group (0 vs. 10.67 mmHg * min; p < 0.01).
- 📉 TWA of MAP of 65 also showed significant reduction (0 vs. 0.07 mmHg; p < 0.01).
- 🚫 No significant difference in postoperative acute kidney injury (AKI) incidence (6.7% vs. 4.2%; p = 0.72).
- 📉 Trend towards lower incidence of myocardial injury after non-cardiac surgery (MINS) in the intervention group (17.1% vs. 31.8%; p = 0.07).
- 🦠 Slight reduction in postoperative infections was observed (16.0% vs. 26.8%; p = 0.16).
📚 Background
Intraoperative hypotension is a common complication during surgeries, particularly in procedures involving single lung ventilation. It can lead to serious postoperative complications, including acute kidney injury (AKI) and myocardial injury. The integration of artificial intelligence in perioperative care presents a promising avenue for enhancing patient outcomes by providing real-time data-driven interventions.
🗒️ Study
Conducted at a university hospital, this pilot study aimed to assess the effectiveness of a goal-directed therapy algorithm based on the Hypotension Prediction Index (HPI). A total of 150 patients were randomly assigned to either the intervention group, which received AI-driven therapy, or the control group, which followed standard care protocols.
📈 Results
The results were compelling, showing that the intervention group experienced a significant reduction in both the frequency and duration of hypotensive episodes. The area under the mean arterial pressure (MAP) of 65 and the time-weighted average (TWA) of MAP were also significantly lower in the intervention group, indicating improved hemodynamic stability during surgery.
🌍 Impact and Implications
The findings from this study highlight the potential of artificial intelligence in enhancing perioperative care. By effectively predicting and managing hypotension, healthcare providers can improve patient safety and potentially reduce the incidence of postoperative complications. This approach could pave the way for broader applications of AI in surgical settings, ultimately leading to better patient outcomes.
🔮 Conclusion
This pilot study demonstrates the promising role of AI in goal-directed therapy for managing intraoperative hypotension during lung surgery. While the intervention did not significantly reduce the incidence of AKI, the trends observed in MINS and postoperative infections suggest that further research is warranted. The integration of AI in surgical protocols could significantly enhance patient care and safety in the future.
💬 Your comments
What are your thoughts on the use of artificial intelligence in surgical settings? Do you believe it can transform patient care? 💬 Share your insights in the comments below or connect with us on social media:
Perioperative goal-directed therapy with artificial intelligence to reduce the incidence of intraoperative hypotension and renal failure in patients undergoing lung surgery: A pilot study.
Abstract
STUDY OBJECTIVE: The aim of this study was to investigate whether goal-directed treatment using artificial intelligence, compared to standard care, can reduce the frequency, duration, and severity of intraoperative hypotension in patients undergoing single lung ventilation, with a potential reduction of postoperative acute kidney injury (AKI).
DESIGN: single center, single-blinded randomized controlled trial.
SETTING: University hospital operating room.
PATIENTS: 150 patients undergoing lung surgery with single lung ventilation were included.
INTERVENTIONS: Patients were randomly assigned to two groups: the Intervention group, where a goal-directed therapy based on the Hypotension Prediction Index (HPI) was implemented; the Control group, without a specific hemodynamic protocol.
MEASUREMENTS: The primary outcome measures include the frequency, duration of intraoperative hypotension, furthermore the Area under MAP 65 and the time-weighted average (TWA) of MAP of 65. Other outcome parameters are the incidence of AKI and myocardial injury after non-cardiac surgery (MINS).
MAIN RESULTS: The number of hypotensive episodes was lower in the intervention group compared to the control group (0 [0-1] vs. 1 [0-2]; p = 0.01), the duration of hypotension was shorter in the intervention group (0 min [0-3.17] vs. 2.33 min [0-7.42]; p = 0.01). The area under the MAP of 65 (0 mmHg * min [0-12] vs. 10.67 mmHg * min [0-44.16]; p < 0.01) and the TWA of MAP of 65 (0 mmHg [0-0.08] vs. 0.07 mmHg [0-0.25]; p < 0.01) were lower in the intervention group. The incidence of postoperative AKI showed no differences between the groups (6.7 % vs.4.2 %; p = 0.72). There was a trend to lower incidence of MINS in the intervention group (17.1 % vs. 31.8 %; p = 0.07). A tendency towards reduced postoperative infection was seen in the intervention group (16.0 % vs. 26.8 %; p = 0.16).
CONCLUSIONS: The implementation of a treatment algorithm based on HPI allowed us to decrease the duration and severity of hypotension in patients undergoing lung surgery. It did not result in a significant reduction in the incidence of AKI, however we observed a tendency towards lower incidence of MINS in the intervention group, along with a slight reduction in postoperative infections.
Author: [‘Habicher M’, ‘Denn SM’, ‘Schneck E’, ‘Akbari AA’, ‘Schmidt G’, ‘Markmann M’, ‘Alkoudmani I’, ‘Koch C’, ‘Sander M’]
Journal: J Clin Anesth
Citation: Habicher M, et al. Perioperative goal-directed therapy with artificial intelligence to reduce the incidence of intraoperative hypotension and renal failure in patients undergoing lung surgery: A pilot study. Perioperative goal-directed therapy with artificial intelligence to reduce the incidence of intraoperative hypotension and renal failure in patients undergoing lung surgery: A pilot study. 2025; 102:111777. doi: 10.1016/j.jclinane.2025.111777