Relevant bibliographies by topics / Hypotension

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Hypotension'

Author: Grafiati
Published: 4 June 2021
Last updated: 22 January 2025

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Journal articles on the topic "Hypotension"

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Baranov, Dimitry, and William M. Armstead. "Selective Blockade of AT1 Receptor Attenuates Impairment of Hypotensive Autoregulation and Improves Cerebral Blood Flow after Brain Injury in the Newborn Pig." Anesthesiology 99, no. 5 (November 1, 2003): 1118–24. http://dx.doi.org/10.1097/00000542-200311000-00018.

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Background Fluid percussion injury (FPI) in piglets produces vasoconstriction of pial arteries (PAs), decreases in cerebral blood flow (CBF), and impairment of hypotensive autoregulation. Two types of angiotensin II receptors, AT1 and AT2, have been identified in the brain. This study characterized the effect of pretreatment with AT1- and AT2-selective antagonists on CBF and hypotensive autoregulation after FPI. Methods Fluid percussion injury was induced in chloralose-anesthetized newborn pigs equipped with closed cranial windows. CBF was determined by the radiolabeled microsphere technique. Results Moderate and severe hypotension (71 +/- 3, 53 +/- 2, and 40 +/- 1 mmHg for normotension, moderate hypotension, and severe hypotension, respectively) elicited PA dilation without changes in CBF in sham control piglets. The AT1 antagonist ZD 7155 partially restored impaired hypotension-induced PA dilation after FPI (19 +/- 1 and 34 +/- 1 vs. 5 +/- 1 and 7 +/- 1 vs. 12 +/- 1 and 20 +/- 3% for PA dilation during moderate and severe hypotension in sham control, FPI, and FPI + ZD 7155 animals, respectively). ZD 7155 also blunted the reductions in CBF during normotension and hypotension observed in untreated animals (43 +/- 4, 38 +/- 5, and 55 +/- 3 vs. 32 +/- 4, 19 +/- 2, and 27 +/- 5% CBF reductions during normotension, moderate hypotension, and severe hypotension in untreated and pretreated animals, respectively). The AT2 selective antagonist PD 123,319 did not restore hypotension-induced PA dilation and did not prevent decreases in CBF observed during normotension and moderate and severe hypotension after FPI. Conclusion These data indicate that blockade of the AT1 and not the AT2 receptor diminished the reduction in hypotensive PA dilation after FPI. AT1 blockade also blunted the decrease in CBF during normotension as well as the further decrease in CBF observed during hypotension after FPI. These data suggest that AT1 receptor activation by angiotensin II contributes to cerebrovascular dysregulation during hypotension after FPI.
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KHAN, MUHAMMAD ASGHAR, SABIHA SHUJAAT, MUHAMMAD RASHID IQBAL, Muhammad Danish Hanif, and Aijaz Ahmed. "INTRA-OPERATIVE HYPOTENSION;." Professional Medical Journal 19, no. 05 (October 8, 2012): 695–99. http://dx.doi.org/10.29309/tpmj/2012.19.05.2400.

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Objective: To determine the frequency of intra-operative hypotension following induction of Anesthesia in patients continuingtheir routine dose of angiotensin system inhibitor therapy before surgery. Study design: Cross-sectional study. Setting: Department ofAnaesthesiology, Combined Military Hospital, Quetta. Duration of study: One year from 20-08-2010 to 19-08-2011. Subjects and methods:Total 92 hypertensive patients were included in this study. Diagnostic criteria for patients was those cases receiving ACEI/ARA therapy for atleast 3 months with admission preoperative arterial blood pressure of >150/90mmHg. Results: Mean age of the patients was 47.70±8.47years. Out of 92 patients, 38 patients (41.3%) were male while remaining 54 patients (58.7%) were female. Distribution of cases by hypotensionafter induction of anesthesia shows, hypotension at 30 minute in 55 patients (59.8%) and hypotension at 60 minute in 37 patients (40.2%). Outof 55 hypotensive patients (at 30 minute) 17 patients (30.9%) had mild hypotension, 32 patients (58.2%) had moderate hypotension and 6patients (10.9%) had severe hypotension. Out of 37 hypotensive patients (at 60 minute) 8 patients (21.6%) had mild hypotension, 25 patients(67.6%) had moderate hypotension and 4 patients (10.8%) had severe hypotension. Conclusions: Hypertensive patients continuing theirroutine angiotensin system inhibitors therapy (<10 hr preoperative) have a variable risk of developing moderate hypotension within 30 minutesafter induction. This moderate hypotension proved to be of little clinical significance as it responded to conventional therapy.
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Ballester, Leonor, Rafael Martínez, Juan Méndez, Gloria Miró, Manel Solsona, Elisabeth Palomera, Josep Capdevila, Alejandro Rodriguez, and Juan Yébenes. "Differences in Hypotensive vs. Non-Hypotensive Sepsis Management in the Emergency Department: Door-to-Antibiotic Time Impact on Sepsis Survival." Medical Sciences 6, no. 4 (October 10, 2018): 91. http://dx.doi.org/10.3390/medsci6040091.

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Background: Sepsis diagnosis can be incorrectly associated with the presence of hypotension during an infection, so the detection and management of non-hypotensive sepsis can be delayed. We aimed to evaluate how the presence or absence of hypotension, on admission at the emergency department, affects the initial management and outcomes of patients with community-onset severe sepsis. Methods: Demographic, clinical, laboratory, process of care, and outcome variables were recorded for all patients, at the emergency department of our university hospital, who presented with community-onset severe sepsis, between 1 March and 31 August in three consecutive years. Patient management consisted of standardized bundled care with five measures: Detection, blood cultures and empirical antibiotics, oxygen supplementation and fluid resuscitation (if needed), clinical monitoring, and noradrenalin administration (if needed). We compared all variables between patients who had hypotension (mean arterial pressure <65 mmHg), on admission to the emergency department, and those who did not. Results: We identified 153 episodes (84 (54.5%) men; mean age 73.6 ± 1.2; mean Sequential Organ Failure Assessment (SOFA) score 4.9 ± 2.7, and 41.2% hospital mortality). Hypotension was present on admission to the emergency department in 57 patients (37.2%). Hemodynamic treatment was applied earlier in patients who presented hypotension initially. Antibiotics were administered 48 min later in non-hypotensive sepsis (p = 0.08). A higher proportion of patients without initial hypotension required admission to the intensive care unit (ICU) (43.1% for patients initially hypotensive vs. 56.9% in those initially non-hypotensive, p < 0.05). Initial hypotension was not associated with mortality. A delay in door-to-antibiotic administration time was associated with mortality [OR 1.150, 95%CI: 1.043–1.268). Conclusions: Initial management of patients with community-onset severe sepsis differed according to their clinical presentation. Initial hypotension was associated with early hemodynamic management and less ICU requirement. A non-significant delay was observed in the administration of antibiotics to initially non-hypotensive patients. The time of door-to-antibiotic administration was related to mortality.
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Martín-Pérez, Mar, Alexander Michel, Mark Ma, and Luis Alberto García Rodríguez. "Development of hypotension in patients newly diagnosed with heart failure in UK general practice: retrospective cohort and nested case–control analyses." BMJ Open 9, no. 7 (July 2019): e028750. http://dx.doi.org/10.1136/bmjopen-2018-028750.

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ObjectivesHypotension is of particular relevance for patients with heart failure (HF), since almost all HF drugs cause lowering of blood pressure (BP) and it is associated with a poor prognosis. We aimed to investigate hypotension incidence and risk factors in patients with incident HF in the UK.DesignRetrospective cohort study including nested case–control analyses.SettingThe Health Improvement Network UK primary care database.Participants18 677 adult patients with incident HF during 2000–2005 were followed and cases of hypotension (systolic BP ≤90 mm Hg) were identified. Controls were age-matched, sex-matched and date-matched to cases (1:2).Primary and secondary outcome measuresWe estimated hypotension incidence in the full study population and relevant subgroups (eg, sex and age). Potential risk factors for hypotension overall and for multiple versus single hypotensive episodes were evaluated using conditional logistic regression and unconditional regression models, respectively.ResultsDuring a mean follow-up of 3.31 years, 2565 patients (13.7%) developed hypotension. The incidence of hypotension was 3.17 cases per 100 patient years (95% confidence interval (CI): 3.05–3.30), and was markedly increased in women aged 18–39 years (n=32; 17.72 cases per 100 patient-years; 95% CI: 9.69–29.73). Hypotension risk factors included high healthcare utilisation (proxy measure for HF severity and general comorbidity; eg, ≥10 primary care physician visits versus none, odds ratio (OR): 2.29; 95% CI: 1.34–3.90), previous hypotensive episodes (OR: 2.32; 95% CI: 1.84–2.92), renal failure and use of aldosterone antagonists, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Risk factors identified for hypotension generally overlapped with those for multiple versus single hypotensive episodes.ConclusionsHypotension occurs frequently in patients with incident HF. Our findings may help identify patients most likely to benefit from close BP monitoring. The increased incidence of hypotension in young women with HF requires investigation.
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Gautam, B., and A. Bhattarai. "Thresholds for Spinal Anaesthesia-induced Hypotension During Caesarean Section." Kathmandu University Medical Journal 19, no. 1 (March 31, 2021): 85–89. http://dx.doi.org/10.3126/kumj.v19i1.49552.

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Background Spinal anaesthesia is the current standard for caesarean section. Hypotension, a common complication, potentially results in adverse foetal and maternal outcomes. However, hypotension-defining criteria are varied. Objective To identify the blood pressure thresholds for spinal anaesthesia-induced hypotension during caesarean section. Method This is a retrospective cohort study of spinal anaesthesia-induced hypotension that occurred till baby-delivery during caesarean section. Reports on intraoperative hypotension, collected previously from January to December 2019, were reviewed to identify the hypotension-defining thresholds. The thresholds were categorized into systolic blood pressure (SBP) of 80, 90 or 100 mmHg, mean arterial pressure (MAP) of 60, 65 or 70 mmHg, combinations, and others. Parturient and anaesthesia characteristics, and associated hypotensive symptoms were also recorded for descriptive analysis. Result Spinal anaesthesia-induced hypotension was identified in 129 (11.5%) cases among 1116 caesarean sections. Altogether, 12 hypotension-defining thresholds were employed. Thresholds of SBP 90, MAP 60, and SBP 80 mmHg were used in 53 (41%), 28 (21.7%), and 21 (16.2%) cases respectively. Mean maternal age was 28 (±4.22) years and 87 (67.4%) cases underwent emergency surgery. Median sensory blockade level was T4. Nausea-vomiting, bradycardia, and tachycardia were associated during five (3.8%), six (4.6%), and 15 (11.6%) hypotensive incidents respectively. Two cases had unrecordable blood pressure but there was no maternal mortality. Conclusion Systolic blood pressure of 90 mmHg and mean arterial pressure of 60 mmHg included the most common thresholds for spinal anaesthesia-induced hypotension during caesarean section. Identifying the safe and clinically relevant hypotension-defining criteria needs further investigation.
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Klijn, Eva, A. B. Johan Groeneveld, Michel E. van Genderen, Michiel Betjes, Jan Bakker, and Jasper van Bommel. "Peripheral Perfusion Index Predicts Hypotension during Fluid Withdrawal by Continuous Veno-Venous Hemofiltration in Critically Ill Patients." Blood Purification 40, no. 1 (2015): 92–98. http://dx.doi.org/10.1159/000381939.

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Aim: Peripheral perfusion may predict harmful hypovolemic hypotension during fluid withdrawal by continuous veno-venous hemofiltration (CVVH) in critically ill patients with acute kidney injury. Methods: Twenty-three critically ill AKI patients were subjected to progressive fluid withdrawal. Systemic hemodynamics and peripheral perfusion index (PPI) by pulse oximetry, forearm-to-fingertip skin temperature gradient (Tskin-diff) and tissue oxygen saturation (StO2, near infra-red spectroscopy) were measured. Results: Most hemodynamic values decreased with fluid withdrawal, particularly in the hypotensive group, except for stroke volume (SV) and cardiac output, which decreased to a great extent in the non-hypotensive patients. Increases in systemic vascular resistance (SVR) were less in hypotension. Baseline pulse pressure and PPI were lower in hypotensive (n = 10) than non-hypotensive patients and subsequent PPI values paralleled SV decreases. A baseline PPI ≤0.82 AU predicted hypotension with a sensitivity of 70%, and a specificity of 92% (AUC 0.80 ± 0.11, p = 0.004). Conclusion: Progressive fluid withdrawal during CVVH is poorly tolerated in patients with less increases in SVR. The occurrence of hypotension can be predicted by low baseline PPI.
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Murabito, Paolo, Marinella Astuto, Filippo Sanfilippo, Luigi La Via, Francesco Vasile, Francesco Basile, Alessandro Cappellani, Lucia Longhitano, Alfio Distefano, and Giovanni Li Volti. "Proactive Management of Intraoperative Hypotension Reduces Biomarkers of Organ Injury and Oxidative Stress during Elective Non-Cardiac Surgery: A Pilot Randomized Controlled Trial." Journal of Clinical Medicine 11, no. 2 (January 13, 2022): 392. http://dx.doi.org/10.3390/jcm11020392.

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Background: Intraoperative hypotension is associated with increased postoperative morbidity and mortality. Methods: We randomly assigned patients undergoing major general surgery to early warning system (EWS) and hemodynamic algorithm (intervention group, n = 20) or standard care (n = 20). The primary outcome was the difference in hypotension (defined as mean arterial pressure < 65 mmHg) and as secondary outcome surrogate markers of organ injury and oxidative stress. Results: The median number of hypotensive episodes was lower in the intervention group (−5.0 (95% CI: −9.0, −0.5); p < 0.001), with lower time spent in hypotension (−12.8 min (95% CI: −38.0, −2.3 min); p = 0.048), correspondent to −4.8% of total surgery time (95% CI: −12.7, 0.01%; p = 0.048).The median time-weighted average of hypotension was 0.12 mmHg (0.35) in the intervention group and 0.37 mmHg (1.11) in the control group, with a median difference of −0.25 mmHg (95% CI: −0.85, −0.01; p = 0.025). Neutrophil Gelatinase-Associated Lipocalin (NGAL) correlated with time-weighted average of hypotension (R = 0.32; p = 0.038) and S100B with number of hypotensive episodes, absolute time of hypotension, relative time of hypotension and time-weighted average of hypotension (p < 0.001 for all). The intervention group showed lower Neuronal Specific Enolase (NSE) and higher reduced glutathione when compared to the control group. Conclusions: The use of an EWS coupled with a hemodynamic algorithm resulted in reduced intraoperative hypotension, reduced NSE and oxidative stress.
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Dolla, Caterina, Alberto Mella, Giacinta Vigilante, Fabrizio Fop, Anna Allesina, Roberto Presta, Aldo Verri, et al. "Recipient pre-existing chronic hypotension is associated with delayed graft function and inferior graft survival in kidney transplantation from elderly donors." PLOS ONE 16, no. 4 (April 5, 2021): e0249552. http://dx.doi.org/10.1371/journal.pone.0249552.

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Background Pre-existing chronic hypotension affects a percentage of kidney transplanted patients (KTs). Although a relationship with delayed graft function (DGF) has been hypothesized, available data are still scarce and inconclusive. Methods A monocentric retrospective observational study was performed on 1127 consecutive KTs from brain death donors over 11 years (2003–2013), classified according to their pre-transplant Mean Blood Pressure (MBP) as hypotensive (MBP < 80 mmHg) or normal-hypertensive (MBP ≥ 80 mmHg, with or without effective antihypertensive therapy). Results Univariate analysis showed that a pre-existing hypotension is associated to DGF occurrence (p<0.01; OR for KTs with MBP < 80 mmHg, 4.5; 95% confidence interval [CI], 2.7 to 7.5). Chronic hypotension remained a major predictive factor for DGF development in the logistic regression model adjusted for all DGF determinants. Adjunctive evaluations on paired grafts performed in two different recipients (one hypotensive and the other one normal-hypertensive) confirmed this assumption. Although graft survival was only associated with DGF but not with chronic hypotension in the overall population, stratification according to donor age revealed that death-censored graft survival was significantly lower in hypotensive patients who received a KT from >50 years old donor. Conclusions Our findings suggest that pre-existing recipient hypotension, and the subsequent hypotension-related DGF, could be considered a significant detrimental factor, especially when elderly donors are involved in the transplant procedure.
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Tiboldi, Akos, Jonas Gernhold, Christian Scheuba, Philipp Riss, Wolfgang Raber, Barbara Kabon, Bruno Niederle, and Martin B. Niederle. "Hypotension with and Without Hypertensive Episodes During Endoscopic Adrenalectomy for Pheochromocytoma or Paraganglioma—Should Perioperative Treatment Be Individualized?" Journal of Clinical Medicine 13, no. 23 (November 22, 2024): 7054. http://dx.doi.org/10.3390/jcm13237054.

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Background: Hemodynamic instability is common during adrenalectomy for pheochromocytoma and paraganglioma (PPGL). Most analyses focus on the risk factors for intraoperative hypertension, but hypotension is a frequent and undesirable phenomenon during PPGL surgery. This study aimed to analyze the risk factors for hypotensive episodes during the removal of PPGL, and whether these episodes are always associated with concomitant intraoperative hypertensive events. Methods: A consecutive series of 121 patients (91.7% receiving preoperative alpha-blockade) treated with transperitoneal endoscopic adrenalectomy at a university hospital were analyzed, and pre- and intraoperative risk factors for intraoperative hypotension with or without intraoperative hypertension were analyzed using univariable and multivariable logistic regression analyses. Results: In total, 58 (56.2%) patients presented with intraoperative hypotension. Of these, 25 (20.7%) patients showed only hypotensive episodes but no hypertensive episodes (group 1), and 43 (35.5%) patients had both intraoperative hypotension and hypertension (group 2). The remaining 53 patients did not present with hypotension at all (group 3). When comparing group 1 (hypotension only) to all other patients with incidental diagnosis, higher age and lower preoperative diastolic arterial blood pressure (ABP) were significant risk factors for intraoperative hypotension; only the latter two were still significant in multivariate analysis. The significant risk factors for hypotension independent of hypertension (group 1 + 2 vs. group 3) were age and incidental diagnosis, pre-existing diabetes mellitus, and intraoperative use of remifentanil. Incidental diagnosis and use of remifentanil reached the level of significance in multivariate analysis. Conclusions: Since older age, incidental diagnosis of PPGL, lower preoperative ABP, and diabetes mellitus are risk factors for intraoperative hypotension, preoperative alpha-blocker treatment should be individualized for those at risk for hypotension. In addition, remifentanil should be used cautiously in the risk group.
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Vukotic, Aleksandra, Jasna Jevdjic, David Green, Milovan Vukotic, Nina Petrovic, Ana Janicijevic, Irina Nenadic, et al. "Detection of hypotension during spinal anesthesia for caesarean section with continuous non-invasive arterial pressure monitoring and intermittent oscillometric blood pressure monitoring in patients treated with ephedrine or phenylephrine." Srpski arhiv za celokupno lekarstvo 149, no. 7-8 (2021): 442–48. http://dx.doi.org/10.2298/sarh200317030v.

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Introduction/Objective. Despite frequent side effects such as hypotension, spinal anesthesia (SA) is still one of the best anesthetic methods for elective cesarean section (CS). Intermittent, oscillometric, noninvasive blood pressure monitoring (NIBP) frequently leads to missed hypotensive episodes. The objective was to compare continuous non-invasive arterial pressure (CNAP) monitoring with NIBP in the terms of efficiency to detect hypotension. Methods. In this study, we compared CNAP and NIBP monitoring for hypotension detection in 76 patients divided into two groups of 38 patients treated with ephedrine (E) or phenylephrine (P), during threeminute intervals, starting from SA, by the end of the surgery. Results. In E group, significantly lower mean systolic blood pressure (SBP) values with CNAP compared with NIBP (p = 0.008) was detected. By monitoring CNAP, we detected 31 (81.6%) hypotensive patients in E group and significantly lower number, 20 (52.6%), with NIBP (p = 0.001), while in P group CNAP detected 34 patients (89.5%) and NIBP only 18 (47.3%), p = 0.001. By monitoring CNAP, we detected significantly higher number of hypotensive intervals in E and P groups (p < 0.001). Umbilical vein pH was lower within hypotensive compared with normotensive patients in E and P groups, with CNAP and NIBP, respectively (p < 0.001, p = 0.027 in E, and p = 0.009, p < 0.001, in P group). Conclusion. CNAP is more efficient in hypotension detection for CS during SA, which allows faster treatment of hypotension, thus improving fetal and maternal outcome.
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Dissertations / Theses on the topic "Hypotension"

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Soucie, Luc. "Exercise hypotension: A retrospective analysis." Thesis, University of Ottawa (Canada), 1994. http://hdl.handle.net/10393/9829.

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This retrospective study assessed the usefulness of a drop and a blunted systolic blood pressure (SBP) response to exercise testing as predictors of multiple or left main coronary artery disease (CAD) as defined by a 'Coronary Score' (CS). Three types of systolic BP response to exercise were used: (1) an increase by more than 20 mmHg (Group I, n = 107), (2) an increase by 20 mmHg or less (Group II, n = 84), and (3) a decrease of at least 10 mmHg (Group III, n = 45). The extent of CAD was significantly greater in groups II and III than in group I (group I, $6.7\pm6.9;$ group II, $9.3\pm7.1;$ group III, $11.7\pm8.5,$ p 0.05). However, the difference was not statistically different between groups II and III which reinforces the value of a blunted SBP response. Treatment outcome also differed between SBP groups. Seventy percent of patients in group I received medical therapy. Over 70% of those in groups II and III underwent coronary angioplasty (PTCA) or coronary bypass surgery (CABG). It was concluded that similarly to a drop in SBP, a blunted SBP response to treadmill exercise testing in patients with known or suspected CAD is a potential indicator of multiple or left main coronary artery disease.
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KOBAYAKAWA, HIROYUKI, ICHIRO TAKAI, SHIGERU NAKAI, TAKAHIRO SHINZATO, and KENJI MAEDA. "Mechanism of Dialysis-induced Hypotension." Nagoya University School of Medicine, 1992. http://hdl.handle.net/2237/17518.

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Bush, Jeremiah G. "Post-Exercise Hypotension in Brief Exercise." TopSCHOLAR®, 2011. http://digitalcommons.wku.edu/theses/1072.

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The purpose of this investigation was to examine whether a single 10 minute bout of exercise, performed at multiple intervals throughout the day to equal 30 minutes, can effectively elicit post-exercise hypotension (PEH). Secondly, it is important to explore whether a light (40% VO2R) or moderate (70% VO2R) intensity is required to elicit PEH within 10 minutes. Subjects (N=11) completed a VO2max test utilizing the Bruce Treadmill protocol. Each subject returned within 3 – 5 days to complete two separate exercising trials. A counter balanced system was employed so that each subject did not perform the same intensity rotation (Counter Balance 1 = 40% VO2R and 70% VO2R for session 1 and session 2, respectively; Counter Balance 2 = 70% VO2R and 40% VO2R for session 1 and session 2). The first session consisted of 3 sessions (morning, noon, evening) separated by an average of 3.5 hours at one of two intensities (40% VO2R or 70% VO2R). The second group of sessions were performed identical to the first, however, the intensity was altered depending upon counter balance. Baseline BP was measured prior to exercising. After each session, BP was measured at 2 intervals for the morning and noon sessions (immediately following and 20 minutes post-exercise); and at 3 intervals for the evening sessions (60 minutes post-exercise added) for both intensities. At 40% VO2R, BP decreased significantly at the morning (p = 0.007), noon (p = 0.018) and evening (p = 0.010) sessions at the 20 minute post-exercise interval. Although not significantly different, BP was observed to be lower at 60 minutes post-exercise interval. During the 70% VO2R session, BP was significantly lower at the morning 20 minute (p = .029) and evening 60 minute post-exercise measurements (p = .006) when compared to baseline. There was no significant difference noted between 40% and 70% VO2R intensities at eliciting a drop in BP at any interval at any time point. Although not statistically significant, 70% VO2R appeared to produce a further decrease at the 60 minute post-exercise measurement (102 mmHg) than did the 40% session (106 mmHg). The results of this study indicate that PEH may be elicited after a single 10 minute exercise session. Furthermore, multiple bouts of 10 minutes produce an accumulated decrease in BP that can be observed at the completion of the day.
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MacDonald, Jay R. "Potential causes and mechanisms of postexercise hypotension." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ66281.pdf.

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Sampaio, Costa Renata. "Hypotension in healthy dogs undergoing elective desexing." Thesis, Sampaio Costa, Renata (2014) Hypotension in healthy dogs undergoing elective desexing. Masters by Research thesis, Murdoch University, 2014. https://researchrepository.murdoch.edu.au/id/eprint/22864/.

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Hypotension is the most common complication during anaesthesia of dogs and contributes to anaesthetic-related morbidity. The frequency of hypotension reported in anaesthetised dogs is quite variable due to the lack of a standardised definition of hypotension and the number of different factors present in each study that could influence the results. In addition, there is no study in the veterinary literature that has attempted to identify animal factors that may influence perioperative mean arterial blood pressure (MAP). The aims of this thesis were to document the proportion of healthy dogs developing hypotension during elective desexing at Murdoch University Veterinary Hospital (MUVH) and investigate patient factors influencing perioperative MAP during a surgical plane of anaesthesia. To achieve these aims, a historical cohort study and two prospective studies were performed. These studies were approved by the Murdoch University Animal Ethics Committee (AEC R239611). The historical cohort study reviewed anaesthetic records from dogs desexed in general practice (GP) between 2007 and 2011. The aim was to determine the frequency of hypotension and explore associations between gender, age, body mass, heart rate and anaesthetic drugs with MAP. Hypotension was defined as MAP <60 mmHg for ≥10 minutes. Records from 188 dogs were included, 87/188 developed hypotension and the frequency of hypotension was higher in younger dogs. However, this study had limitations such as the use of a non-invasive technique for measuring MAP and various anaesthetic protocols were utilised. Prospective studies were thus performed to clarify the previous findings. These studies used invasive blood pressure monitoring (the most accurate method of measuring blood pressure) and a standardised anaesthetic protocol. A prospective study was performed in dogs undergoing elective desexing in student neutering clinics between 2011 and 2012. To determine the proportion of hypotensive dogs, the average of 10 consecutive MAP measurements were recorded every five minutes. Hypotension was defined as above. To investigate factors that influenced MAP, the area under the MAP*time curve (AUC) from 10 minutes before to 40 minutes after the start of surgery was calculated using the trapezoidal method. Association of explanatory variables including gender, age, body mass, urine specific gravity (USG), packed cell volume and total solids with the AUC were explored using regression models. Thirty five of 71 dogs developed hypotension. The combination of age and USG best explained the MAP with age being positively and USG being negatively associated with MAP. A second prospective study was performed to determine if the findings of the previous study could be corroborated in dogs undergoing desexing in GP, where dogs were hospitalised for a shorter period and surgery was performed by experienced veterinarians. As duration of anaesthesia was shorter, the AUC was calculated from 5 minutes before to 30 minutes after the start of surgery. Association of explanatory variables with AUC were explored. The proportion of hypotensive dogs was higher than in student neutering clinics with 17 of 24 dogs developing hypotension. Urine specific gravity was also found to be negatively associated with MAP, which was consistent with the previous study. The observed proportions of hypotensive dogs support the recommendation for blood pressure monitoring during anaesthesia in healthy young dogs and the presence of subclinical dehydration suggested by increases in USG support the administration of intravenous fluids.
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Boone, Louvonia Rose. "Heart rate variability as a predictor of hypotension." [New Haven, Conn. : s.n.], 2008. http://ymtdl.med.yale.edu/theses/available/etd-11212008-110758/.

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Mayaud, Louis. "Prediction of mortality in septic patients with hypotension." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:55a57418-de16-4932-8a42-af56bd380056.

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Sepsis remains the second largest killer in the Intensive Care Unit (ICU), giving rise to a significant economic burden ($17b per annum in the US, 0.3% of the gross domestic product). The aim of the work described in this thesis is to improve the estimation of severity in this population, with a view to improving the allocation of resources. A cohort of 2,143 adult patients with sepsis and hypotension was identified from the MIMIC-II database (v2.26). The implementation of state-of-the-art models confirms the superiority of the APACHE-IV model (AUC=73.3%) for mortality prediction using ICU admission data. Using the same subset of features, state-of-the art machine learning techniques (Support Vector Machines and Random Forests) give equivalent results. More recent mortality prediction models are also implemented and offer an improvement in discriminatory power (AUC=76.16%). A shift from expert-driven selection of variables to objective feature selection techniques using all available covariates leads to a major gain in performance (AUC=80.4%). A framework allowing simultaneous feature selection and parameter pruning is developed, using a genetic algorithm, and this offers similar performance. The model derived from the first 24 hours in the ICU is then compared with a “dynamic” model derived over the same time period, and this leads to a significant improvement in performance (AUC=82.7%). The study is then repeated using data surrounding the hypotensive episode in an attempt to capture the physiological response to hypotension and the effects of treatment. A significant increase in performance (AUC=85.3%) is obtained with the static model incorporating data both before and after the hypotensive episode. The equivalent dynamic model does not demonstrate a statistically significant improvement (AUC=85.6%). Testing on other ICU populations with sepsis is needed to validate the findings of this thesis, but the results presented in it highlight the role that data mining will increasingly play in clinical knowledge generation.
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WAKABAYASHI, T., T. NAITO, T. KINKORI, N. MATSUBARA, T. OHSHIMA, T. IZUMI, O. HOSOSHIMA, S. MIYACHI, and A. TSURUMI. "Can Periprocedural Hypotension in Carotid Artery Stenting Be Predicted ? : A Carotid Morphologic Autonomic Pathologic Scoring Model Using Virtual Histology to Anticipate Hypotension." Thesis, Centauro Srl, 2009. http://hdl.handle.net/2237/16865.

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Covassin, Naima. "Hemodynamic and autonomic patterns during sleep in essential hypotension." Doctoral thesis, Università degli studi di Padova, 2012. http://hdl.handle.net/11577/3425341.

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Over the past decade, a large body of knowledge has been gathered with regard to the nocturnal hemodynamic pattern, as well as the comorbidity with sleep disturbances, in several cardiovascular diseases, such as hypertension. Nevertheless, surprisingly few attention has been paid to the hypotensives states. In particular, there is paucity of studies addressing sleep in essential hypotension. Essential hypotension represents a form of chronic low blood pressure that is not due to medical or orthostatic conditions. Unlike the other forms of hypotension and although sufferers endorse a variety of subjective distressing symptoms included sleep complaints, essential hypotension remains a poorly addressed topic. Considering in particular its pathogenesis, an autonomic dysfunction in terms of a sympathetic hypoactivation has been postulated as underlying this condition. The present dissertation aims at providing a comprehensive picture of the hemodynamic and autonomic pattern during sleep as well as the sleep pattern in essential hypotension in comparison to normotensive state. The aim of the Experiment 1 was to survey the overnight profile of cardiovascular activity during a night of sleep in essential hypotensives by means of a wide range of measures derived from blood pressure monitoring, impedance cardiography and heart rate variability. In addition, in order to clarify the postulated autonomic imbalance in hypotensives, we sought to examine the nocturnal cardiac autonomic regulation by assessing the involvement of both neurovegetative divisions. Hypotensives displayed diminished cardiovascular output over the sleep period in comparison to normotensives, which was likely driven by the finding of both sympathetic hypoactivation and vagal hyperactivity in essential hypotension. Afterwards, the focus has been turned on the sleep structure. The purpose of the Experiment II was twofold. Firstly, we aimed at evaluating the sleep quality and quantity in this condition in depth, by describing the sleep parameters through polysomnographic recording. Secondly, we studied the cardiovascular and autonomic patterns as a function of the sleep stage to assess whether hypotensives have a different regulation across sleep stages compared with normotensives. Comparisons over the sleep parameters failed to identify any group differences in sleep pattern, whereas lower blood pressure and myocardial contractility associated with a decreased sympathovagal balance in hypotensives across sleep stages corroborated the nighttime cardiovascular hypoactivation and autonomic dysregulation illustrated in the Experiment I. Lastly, since arousals from sleep are associated with transient elevations in cardiovascular activity, the analysis of changes in heart rate elicited by arousals from sleep was carried out in the Experiment III to assess the cardiovascular reactivity in essential hypotension. Hypotensive individuals exhibited a larger heart rate response over the early post arousal beats compared to normotensives, whilst groups did not differ in terms of neither the number nor the duration of arousals experienced during sleep. Given that the cardiac arousal response is primarily mediated by the parasympathetic division, this finding suggests a greater vagal withdrawal in hypotensive subjects than in normotensives, providing further support to the hypothesized parasympathetic hyperactivity in essential hypotension. To summarize, our findings of sympathetic withdrawal matched with vagal hyperactivity underlying the nocturnal cardiovascular activity confirm and extend the hypothesis of autonomic imbalance in essential hypotension, showing that both neurovegetative branches functions are altered in this condition. Nevertheless, since no group differences were detected with regard to the objective sleep parameters, the sleep quality and quantity appear to be preserved in this disorder.
A partire dallo scorso decennio, è stata ampiamente approfondita la conoscenza relativa all’andamento dei parametri cardiovascolari durante la notte, così come la comorbidità con disturbi del sonno, in numerose patologie cardiovascolari quale l’ipertensione arteriosa. Tuttavia, sorprendentemente limitata attenzione è stata prestata agli stati ipotensivi. In particolare, scarseggiano gli studi volti ad esaminare il sonno nell’ipotensione essenziale. L’ipotensione essenziale rappresenta una forma cronica di bassa pressione sanguigna non conseguente a condizioni mediche o ortostatiche. A differenza delle altre forme di ipotensione e nonostante i soggetti che ne soffrono lamentino una varietà di sintomi soggettivi inclusi difficoltà nel sonno, l’ipotensione essenziale rimane un tema insufficientemente indagato. Considerando in particolare la patogenesi, una disfunzione autonoma in termini di ipoattivazione simpatica è stata ipotizzata alla base di tale condizione. La presente tesi si propone di fornire una descrizione esaustiva dell’andamento emodinamico e autonomo durante il sonno e del pattern ipnico nell’ipotensione essenziale in confronto con lo stato normotensivo. L’obiettivo dell’Esperimento I era quello di indagare il profilo notturno dell’attività cardiovascolare durante una notte di sonno in ipotési essenziali mediante l’impiego di un ampio spettro di misure derivate dal monitoraggio pressorio, dalla cardiografia ad impedenza e dall’analisi della variabilità della frequenza cardiaca. Inoltre, al fine di chiarire l’ipotesi di sbilancio autonomo avanzata circa la patogenesi dell’ipotensione essenziale, abbiamo esaminato la regolazione cardiaca autonoma notturna valutando il ruolo di entrambe le divisioni neurovegetative. Gli ipotési, confrontati con normotesi, hanno mostrato una ridotta attività cardiovascolare lungo il periodo di sonno, verosimilmente mediata dalle ipoattivazione simpatica e iperattivazione vagale riscontrate nell’ipotensione essenziale. Il focus è stato quindi rivolto alla struttura del sonno. L’Esperimento II presentava un duplice scopo. In primo luogo, ci siamo proposti di esaminare approfonditamente la qualità e quantità di sonno nella condizione ipotensiva, attraverso la descrizione dei parametri sonno derivati dalla registrazione polisonnografica. In secondo luogo, abbiamo studiato i pattern cardiovascolare e autonomo in funzione dello stadio di sonno al fine di valutare se gli ipotési, confrontati con normotesi, mostrassero una differente regolazione fisiologica lungo tali stadi. I confronti effettuati circa i parametri sonno non hanno rilevato alcuna differenza di gruppo nel pattern ipnico, mentre i risultati di ridotte pressione sanguigna e contrattilità miocardica, unitamente ad un diminuito bilancio simpatovagale esibiti dagli ipotési lungo gli stadi di sonno hanno fornito supporto ai dati di ipoattivazione cardiovascolare notturna e disregolazione autonoma precedentemente illustrate nell’Esperimento I. Infine, dal momento che gli arousal notturni sono associati a transitori incrementi nei parametri cardiovascolari, nell’Esperimento III è stata condotta l’analisi delle variazioni di frequenza cardiaca elicitate dagli arousal notturni per indagare la reattività cardiovascolare nell’ipotensione essenziale. I soggetti ipotési hanno esibito una più marcata risposta cardiaca rispetto ai normotesi a livello dei battiti cardiaci immediatamente successivi all’insorgenza dell’arousal, mentre non si sono riscontrate differenze di gruppo relativamente né al numero né alla durata media degli arousal esperiti durante il sonno. Poiché la risposta cardiaca agli arousal è prevalentemente modulata dalla divisione parasimpatica, questo risultato suggerisce un maggiore ritiro vagale negli ipotési in confronto con i normotesi, avvalorando così ulteriormente l’ipotesi di iperattività vagale sottesa all’ipotensione essenziale. In conclusione, i risultati da noi riportati indicanti un ritiro simpatico congiuntamente ad un’iperattività vagale alla base dell’attività cardiovascolare notturna sostengono ed ampliano l’ipotesi di sbilancio autonomo postulata nell’ipotensione essenziale, suggerendo come entrambe le branche neurovegetative evidenzino alterazioni funzionali in tale condizione. Tuttavia, dal momento che non si sono rilevate differenze di gruppo circa i parametri sonno oggettivi, la qualità e quantità di sonno appaiono preservate in questo disturbo.
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Hisbergues, Alexandre Benetos Athanase. "Polymédication de la personne âgée étude des caractéristiques et déterminants /." [S.l.] : [s.n.], 2008. http://www.scd.uhp-nancy.fr/docnum/SCDMED_T_2008_HISBERGUES_ALEXANDRE.pdf.

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Books on the topic "Hypotension"

1

R, MacRae W., and Wildsmith J. A. W, eds. Induced hypotension. Amsterdam: Elsevier, 1991.

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Heuser, D., D. G. McDowall, and V. Hempel, eds. Controlled Hypotension in Neuroanaesthesia. Boston, MA: Springer US, 1985. http://dx.doi.org/10.1007/978-1-4613-2499-7.

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Erwin Riesch Symposium (1981 Tübingen, Germany). Controlled hypotension in neuroanaesthesia. New York: Plenum Press, 1985.

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Isik, Ahmet Turan, and Pinar Soysal, eds. Orthostatic Hypotension in Older Adults. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-62493-4.

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Savko, Lili︠i︡a. Vysokoe i nizkoe davlenie: Prichiny, profilaktika i lechenie. Sankt-Peterburg: Piter, 2013.

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Weiner, Ed. Blood pressure: Questions you have-- answers you need. New York: Wings Books, 1993.

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Peter, Schwab. Der hypotonische Beschwerdenkomplex: Theorie und Praxis der essentiellen Hypotonie. Göttingen: Hogrefe, 1992.

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Ustelimova, S. V. Massazh pri gipertonii i gipotonii. Moskva: Veche, 2003.

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Schraermeyer, Johanna. Kontrollierte Hypotension mit Nitroglycerin bei totalendoprothetischem Hüftgelenksersatz: Eine prospektive klinische Untersuchung. [s.l.]: [s.n.], 1985.

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(Pakistan), National Book Foundation, ed. Blaḍ praishar ke ʻavāriz̤: Homiyopaithik tarīqah-yi ʻilāj aur jadīd sāiʼns. Islāmābād: Naishnal Buk Fāʼundeshan, 2007.

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Book chapters on the topic "Hypotension"

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Inoue, Tsuyoshi. "Hypotension." In The Concise Manual of Apheresis Therapy, 177–85. Tokyo: Springer Japan, 2013. http://dx.doi.org/10.1007/978-4-431-54412-8_17.

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Alakkassery, Suraj. "Hypotension." In Cardiovascular Disease and Health in the Older Patient, 135–51. Chichester, UK: John Wiley & Sons, Ltd, 2012. http://dx.doi.org/10.1002/9781118451786.ch6.

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Woerlee, G. M. "Hypotension." In Common Perioperative Problems and the Anaesthetist, 40–55. Dordrecht: Springer Netherlands, 1988. http://dx.doi.org/10.1007/978-94-009-1323-3_10.

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Alakkassery, Suraj. "Hypotension." In Pathy's Principles and Practice of Geriatric Medicine, 461–70. Chichester, UK: John Wiley & Sons, Ltd, 2012. http://dx.doi.org/10.1002/9781119952930.ch39.

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Tritapepe, Luigi, Cecilia Nencini, and Demetrio Tallarico. "Hypotension." In Echocardiography for Intensivists, 275–82. Milano: Springer Milan, 2012. http://dx.doi.org/10.1007/978-88-470-2583-7_30.

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Tritapepe, Luigi, Cecilia Nencini, Giulia Frasacco, and Demetrio Tallarico. "Hypotension." In Textbook of Echocardiography for Intensivists and Emergency Physicians, 305–15. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-99891-6_31.

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Lahrmann, H., P. Cortelli, M. Hilz, C. J. Mathias, W. Struhal, and M. Tassinari. "Orthostatic Hypotension." In European Handbook of Neurological Management, 469–75. Oxford, UK: Wiley-Blackwell, 2010. http://dx.doi.org/10.1002/9781444328394.ch33.

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Pang, Allan, Ravi Chauhan, and Tom Woolley. "Permissive Hypotension." In Damage Control Resuscitation, 101–15. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-20820-2_6.

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Heck, Michael, and Michael Fresenius. "Kontrollierte Hypotension." In Repetitorium Anaesthesiologie, 457–67. Berlin, Heidelberg: Springer Berlin Heidelberg, 2001. http://dx.doi.org/10.1007/978-3-662-12917-3_28.

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Friedewald, Vincent E. "Orthostatic Hypotension." In Clinical Guide to Cardiovascular Disease, 963–75. London: Springer London, 2016. http://dx.doi.org/10.1007/978-1-4471-7293-2_72.

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Conference papers on the topic "Hypotension"

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Zhao, Shuoyan, Alan Hamo, Niki Ottenhof, Jan-Wiebe H. Korstanje, and Justin Dauwels. "Prediction of Postinduction Hypotension by Machine Learning." In 2024 46th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 1–4. IEEE, 2024. https://doi.org/10.1109/embc53108.2024.10782974.

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Khot, Aditya Anil, P. B. Jamale, V. K. Dhulkhed, and P. B. Patil. "Prediction of Hypotension Following Subarachnoid Block in C-section Using Perfusion Index." In 2024 International Conference on Healthcare Innovations, Software and Engineering Technologies (HISET), 22–26. IEEE, 2024. http://dx.doi.org/10.1109/hiset61796.2024.00022.

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Park, C., L. Bernhardt, and E. Bondarsky. "Hypocalcemia: A Rare Cause of Hypotension." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a5160.

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Oliveira Miranda, Mariana, Gustavo Luis Behrens Pinto, Renata Borges de Lima, Maria de Lourdes Castro de Oliveira Figueiroa, Alisson Regis de Santana, Viviane Leal Novais, Victor Pereira Mattos, Tamires Cristina Martins de Vasconcelos, and Mittermayer Barreto Santiago. "Intracranial hypotension in a SLE patient." In SBR 2021 Congresso Brasileiro de Reumatologia. Sociedade Brasileira de Reumatologia, 2021. http://dx.doi.org/10.47660/cbr.2021.2151.

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Nair, Pramod, Sanchari Chakravarty, Samyar Siadati, Anum Saeed, and Nitin Rachwani. "1340 Chronic orthostatic hypotension in children." In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference, Liverpool, 28–30 June 2022. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2022. http://dx.doi.org/10.1136/archdischild-2022-rcpch.693.

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Gheith, Salma, and Ahmed F. Al-Sadek. "Prediction of Hypotension in Hemodialysis Session." In 2022 International Conference on Electrical, Computer and Energy Technologies (ICECET). IEEE, 2022. http://dx.doi.org/10.1109/icecet55527.2022.9873042.

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Waheed, S., H. M. Zubair, and M. R. Zafar. "A Rare Occult Malignancy Causing Persistent Hypotension." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6527.

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Dwij, Mehta, Cheema Sanjay, Glover Sophie, Davagnanam Indran, Qureshi Ayman, Kamourieh Salwa, and Matharu Manjit. "Defining orthostatic headache in spontaneous intracranial hypotension." In Association of British Neurologists: Annual Meeting Abstracts 2023. BMJ Publishing Group Ltd, 2023. http://dx.doi.org/10.1136/jnnp-2023-abn.85.

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Labar, A. S., R. Correa Fabiano Filho, and T. Nyunoya. "Recurrent Manifestation of Hypothermia, Hyperhidrosis, and Hypotension." In American Thoracic Society 2023 International Conference, May 19-24, 2023 - Washington, DC. American Thoracic Society, 2023. http://dx.doi.org/10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a1733.

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Miller, Daniel, Andrew Ward, Nicholas Bambos, Andrew Shin, and David Scheinker. "Noninvasive Identification of Hypotension Using Convolutional-Deconvolutional Networks." In 2019 IEEE International Conference on E-health Networking, Application & Services (HealthCom). IEEE, 2019. http://dx.doi.org/10.1109/healthcom46333.2019.9009594.

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Reports on the topic "Hypotension"

1

Tsai, Peichun, and Li Ying Cheng. A systematic review and meta-analysis of the effectiveness of hypotension predictor index in preventing intraoperative hypotension. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2023. http://dx.doi.org/10.37766/inplasy2023.5.0098.

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Kok, Bram, David Wolthuis, Frank Bosch, Hans van der Hoeven, and Michiel Blans. Point-of-care ultrasound in patients with dyspnea, nontraumatic hypotension, and shock: a systematic review protocol. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0020.

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Review question / Objective: To summarize the existing literature on point-of-care ultrasound in dyspnea, nontraumatic hypotension, and shock. Condition being studied: Patients with dyspnea, nontraumatic hypotension, and shock who were assessed using point-of-care ultrasound. Information sources: The electronic databases PubMed and Embase were searched. In addition we reviewed the reference lists of included papers.
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Li, Zifeng, Luhuan Yang, Zuyang Xi, Dongling Ma, and Yunhong Lei. Prediction models for intradialytic hypotension in dialysis patients: a protocol for systematic review and critical appraisal. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2023. http://dx.doi.org/10.37766/inplasy2023.11.0081.

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Liu, Yiping, Yifan Jiang, Jingyi Wang, and Yan Shi. The relationship between orthostatic hypotension and cognitive impairment in Parkinson's disease : a systematic review and Meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2024. http://dx.doi.org/10.37766/inplasy2024.9.0130.

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Jee, Young Seok, and Hyun Kang. Comparison of norepinephrine versus phenylephrine to prevent hypotension after spinal anesthesia for cesarean section: systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2023. http://dx.doi.org/10.37766/inplasy2023.8.0048.

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Pang, Qianyun, Liping Duan, Yan Jiang, and Hongliang Liu. Risk factors of postinduction hypotension in adult surgical patients undergoing general anesthesia, a systematic review and meta-analysis from observational studies. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2021. http://dx.doi.org/10.37766/inplasy2021.5.0098.

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Harris, Gregory, Brooke Hatchell, Davelin Woodard, and Dwayne Accardo. Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0010.

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Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.
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Kramer, George C. Closed-Loop Resuscitation of Hemorrhagic Shock: Novel Solutions Infused to Hypotensive and Normotensive Endpoints. Fort Belvoir, VA: Defense Technical Information Center, June 2007. http://dx.doi.org/10.21236/ada470719.

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Zhu, Siyuan, and Jun Xiong. Effectiveness and safety of traditional Chinese medicine in the treatment of senile hypotension：A protocol for systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, November 2020. http://dx.doi.org/10.37766/inplasy2020.11.0091.

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Schreiber, Martin A. The Effect of Hypotensive Resuscitation and Fluid Type on Mortality, Bleeding, Coagulation and Dysfunctional Inflammation in a Swine Grade V Liver Injury Model. Fort Belvoir, VA: Defense Technical Information Center, January 2008. http://dx.doi.org/10.21236/ada490734.

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