BAP Academy Podcast •
Perioperative Hypotension: When to Treat and What to Give
A practical and clinically focused discussion of perioperative hypotension, blood pressure targets, fluids and vasopressors.
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Learning objectives
- Define clinically relevant perioperative hypotension.
- Explain why the depth and duration of hypotension matter.
- Identify the main physiological mechanisms causing hypotension.
- Select fluids, vasopressors or inotropes according to the underlying mechanism.
- Structure an EDAIC Part II answer on intraoperative hypotension.
Key take-home messages
- The clinical risk of hypotension depends on both its depth and duration.
- Hypotension is a physiological sign, not a diagnosis.
- Fluids should be used for inadequate preload, not for every low blood pressure.
- Vasopressor selection should consider vascular tone, heart rate and cardiac function.
- Treat the underlying physiology, not only the number on the monitor.
References and suggested reading
- Saugel B, et al. PeriOperative Quality Initiative international consensus statement on perioperative arterial pressure management. Br J Anaesth. 2024;133:264–276.
- Salmasi V, et al. Relationship between intraoperative hypotension and acute kidney and myocardial injury after noncardiac surgery. Anesthesiology. 2017;126:47–65.
- Wesselink EM, et al. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth. 2018;121:706–721.
- Futier E, et al. Effect of individualized versus standard blood pressure management strategies on postoperative organ dysfunction: the INPRESS trial. JAMA. 2017;318:1346–1357.
