The Problem: Preventable Hypotension
Mortality during the 30 days after surgery is the third-leading cause of death in the United States [1] with the largest attributable factor being myocardial injury. [2] The only modifiable factor associated with perioperative myocardial injury is hypotension, with many studies in many populations from many institutions showing strong associations between perioperative hypotension and myocardial injury, acute kidney injury, and death. [3-5] Although hemodynamic management is a core skill for anesthesiologists, numerous studies show that even experienced anesthesiologists cannot tightly control blood pressure—and that the effort distracts from other tasks. For example, patients with manually controlled vasopressor infusions in both the operating room and intensive care unit spend 10-15% of their time with preventable perioperative hypotension. [6,7] There is thus a substantial gap between our knowledge of the importance of the avoidance of perioperative hypotension and the actual clinical management. This points to a critical need for a novel approach to management of vasopressors in these environments to bridge this gap; otherwise, evidence has shown that no amount of directed education or attention to this problem will significantly change current performance [8,9], and patients will continue to suffer preventable morbidity and mortality as a result.
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Each year there are more than 300 million surgeries performed worldwide; hypotension remains a key preventable driver of morbidity and mortality in these patients. Similarly, vasoplegic conditions like septic shock are one of the main drivers of ICU admissions worldwide and a focus area that is ripe for innovation.
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The goal of Perceptive Medical is to reduce preventable morbidity and mortality arising from the preventable hypotension that occurs in the ICU and during surgery while simultaneously reducing bedside provider workload.
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References
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