Hypotension Prediction Index (HPI) and Assisted Fluid Management (AFM) for Perioperative Hemodynamic Optimization in Patients Under General Anesthesia
The Use of the Hypotension Prediction Index (HPI) Combined With the Assisted Fluid Management (AFM) Software for Perioperative Hemodynamic Optimization in Patients Undergoing General Anesthesia.
National and Kapodistrian University of Athens
100 participants
Mar 15, 2026
INTERVENTIONAL
Conditions
Summary
This study investigates if the Hypotension Prediction Index (HPI) combined with the Assisted Fluid Management (AFM) software can improve perioperative hemodynamic management in adult patients undergoing general anesthesia. The main question is : Does the HPI and AFM software reduce the incidence and duration of intraoperative hypotension? Does the HPI and AFM software optimize fluid and vasopressor administration? Does the HPI and AFM software improve perioperative outcomes? Participants will be randomly allocated to either an experimental group receiving goal directed hemodynamic therapy guided by HPI and AFM or a control group receiving conventional hemodynamic management.
Eligibility
Inclusion Criteria6
- Age > 18 years
- Intraoperative monitoring > 2 hours or general anesthesia > 2 hours
- Invasive arterial pressure monitoring
- Target MAP ≥ 65 mm Hg intraoperatively
- Written informed consent preoperatively
- ASA Physical Status ≤ 4
Exclusion Criteria4
- Target MAP other than 65 mm Hg
- Severe preoperative hypotension (MAP < 65 mm Hg)
- Severe heart failure (e.g. LVEF < 20%)
- Emergency surgery
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Interventions
The Acumen IQ sensor will be used with the Hemosphere monitor to guide goal-directed hemodynamic therapy. HPI predicts impending hypotension and AFM guides fluid administration. Clinicians will follow a protocol algorithm to prevent or treat intraoperative hypotension with fluids, vasopressors or inotropes.
Participants receive hemodynamic management based on the anesthesiologist's clinical judgement. The Acumen IQ sensor will be placed , but HPI and AFM outputs are not visible to the clinician.
Locations(1)
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NCT07301307