Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery

Abstract

Objective: To determine the effect of individualized blood pressure management targeted upon the physiology of individual patient could help in decreasing the risk postoperative organ dysfunction.  Methodology It was a randomized trial carried out in department of general medicine from March 2016 to March 2017. An approval from Ethics committee was taken. An informed consent in the form of a written document was taken from every patient. Data was analyzed by using SPSS version 24. Student t-test and χ2 test that was unadjusted was performed for the analysis of primary outcome. P value ≤ 0.05 was considered as significant. Results: in the Individualized group, Primary composite outcome was noted as (36.7%) n=55. Acute kidney injury according to RIFLE criteria; Risk, injury and failure was observed as (17.3%) n=26, (9.3%) n=14 and (6%) n=9 respectively. Use of renal replacement therapy was noted as (8%) n=12. Acute heart failure occurred in (6%) n=9. respectively. For Standard treatment group, Primary composite outcome was noted as (48.7%) n=73. Use of renal replacement therapy was noted as (6.7%) n=10. Acute heart failure occurred in (1.3%) n=2. Need for noninvasive or invasive ventilation and sepsis was noted as (30.7%) n=46 and (18%) n=27 respectively. Conclusion: High Postoperative risk patients having major abdominal surgery, the mode of management directed towards the individual blood pressure as compared to standard mode of management proves to be fruitful in decreasing the risk for postoperative organ dysfunction.

Keywords: Blood Pressure, Organ Dysfunction, Postoperative complications, Sepsis.