While there are many challenges in high-risk surgery, the most alarming complication for the ImPrOve Think Tank is haemodynamic instability, manifested as drops in blood pressure, and known as intraoperative hypotension.
During high-risk surgery it is vital that blood continues to flow to organs. If blood pressure drops, and organs don’t get enough blood, the higher the risk of severe postoperative complications, such as myocardial injury, acute kidney injury, and increased mortality.4 These drops in blood pressure are known as intraoperative hypotension (IOH) and are common during surgery under general anaesthesia, occurring in up to 99% of patients.2
It has the potential to cause tissue damage in any vital organ, but the heart and kidneys are most affected. Recent studies show associations between IOH and increased risk of acute kidney injury (AKI) and myocardial injury – the leading cause of post-operative mortality.4 Postsurgical patients with AKI and myocardial injury stay longer in hospital, have higher readmission rates, and cost more to care for, placing a strain on European healthcare systems.7
By 2050, it is predicted that 1 in 4 people could be over 65.8 This brings a myriad of potential health challenges for surgeons and anaesthetists – particularly with haemodynamic instability reported as high as 83% in more senior patients.9 With rates so elevated, the ImPrOve Think Tank believe haemodynamic instability to be a likely cause of a significant proportion of modifiable postoperative mortality and morbidity in Europe.
Image sourced and designed using resources from Freepik.com.