Cardiovascular events after non-cardiac surgery
Conditions
Interventions
Conventional intraoperative blood pressure management group:To maintain intraoperative MAP at or above 65 mmHg
Intensive intraoperative blood pressure management group:Continuous infusion of norepinephrine to maintain intraoperative MAP at or above 80 mmHg
Sponsors
Southern Medical University Nanfang Hospital
Eligibility
Sex/Gender
All
Age
45 Years to No maximum
Inclusion criteria
Inclusion criteria: (1) Aged = 45 years; (2) Undergoing major abdominal surgery under general anesthesia (expected surgery time = 2h, expected length of postoperative stay = 2d); (3) Fulfill =1 of the following criteria (a-f): a. history of coronary artery disease; b. history of stroke; c. history of peripheral arterial disease; d. history of congestive heart failure; e. preoperative NT-proBNP >300 ng/L f. preoperative hs-cTnT >14ng/L; or fulfill =2 of the following criteria (g-m); g. history of chronic kidney disease; h. history of diabetes; i. smoking in the past =2 years; j.= 65 years of age; k. history of hypertension l. history of hypercholesterolemia; m. history of TIA.
Exclusion criteria
Exclusion criteria: (1) ASA score =5; (2) Severe untreated or uncontrolled hypertension (preoperative SBP>180mmHg and/or DBP>110mmHg); (3) Preoperative MAP<80mmHg; (4) End-stage renal disease requiring renal-replacement therapy; (5) Acute cardiovascular event within 1 month of surgery, including acute heart failure, acute coronary syndrome and stroke; (6) Preoperative sepsis or septic shock; (7) Preoperative requirment of vasopressor infusion; (8) Participation in another interventional study; (9) Refusal to participate; (10) Pregnant or breastfeeding women.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| major adverse cardiac events (a composite of myocardial injury/infarction, heart failure, stroke, pulmonary embolism, cardiac arrest, and cardiovascular death after surgery); | — |
Secondary
| Measure | Time frame |
|---|---|
| myocardial injury;heart failure;stroke;pulmonary embolism;cardiac arrest;all-cause mortality;major non-cardiovascular complications;length of stay in ICU;postoperative length of stay in hospital;intraoperative hypotension;intraoperative hypertension;recovery of bowel function;disability-free survival;major adverse cardiac events;all-cause mortality; | — |
Countries
China
Contacts
Public ContactKexuan Liu
Southern Medical University Nanfang Hospital
Outcome results
None listed