Perioperative hypotension

Perioperativna hipotenzija (PH) oblik je hipotenzije povezan s anesteziološkom i kirurškom intervencijom, a očituje se smanjenjem srednjeg arterijskog tlaka (eng. mean arterial pressure, MAP) u periodu od zaprimanja pacijenta u bolnicu do njegova otpuštanja. U tom smislu razlikujemo preoperativnu, intraoperativnu i postoperativnu hipotenziju. PH je relativno česta komplikacija tijekom kirurškog zahvata. Javlja se zbog smanjene kardiovaskularne funkcije u kardioloških bolesnika, intraoperativnog krvarenja, anafilaksije, a djelomično i zbog kardiodepresivnog učinka anestetika u anesteziološkom postupku. PH može dovesti do ozbiljnih komplikacija u pacijenta te negativno utjecati na stope morbiditeta i mortaliteta u postoperativnom periodu. Svrha ovog rada je razmotriti incidenciju i etiologiju PH, razne pristupe njezina zbrinjavanja te dati uvid u dijagnostiku navedenog stanja. Također je bitno osvrnuti se i na potencijalni rizik nastajanja komplikacija u određenoj populaciji pacijenata, koje niz posljedica poput dužeg boravka u bolnici, povećane stope intrahospitalnih infekcija, većeg financijskog opterećenja zdravstvenog sustava te povećane stope mortaliteta. Nadalje, bit će ukratko spomenuti i modeli ranog uočavanja i prevencije PH u intraoperativnom procesu.Perioperative hypotension (PH) is a form of hypotension associated with the surgical and anesthesiological intervention and is characterized by a decrease in mean arterial pressure in the perioperative period. In that sense, PH can be further subdivided into preoperative, intraoperative and postoperative hypotension. PH is a relatively common complication during surgical procedures. It is caused by decreased cardiovascular competence in patients with cardiovascular disease, intraoperative blood loss, anaphylaxis, and, partly, as a consequence of cardiodepressive anesthetic drugs during anesthetic procedures. PH can lead to serious complications and negatively affect the morbidity and mortality rate in the postoperative period. The purpose of this thesis is to consider the incidence, etiology, different approaches to managing PH and to give insight into the diagnostic process of this condition. Furthermore, it is important to reflect on the potential risks of postoperative complications in certain patient populations which could lead to prolonged hospital stay, increased rate of intrahospital postoperative infections, greater financial burden on the healthcare system and increased rate of mortality. Intraoperative PH early-detection and prevention models will also be briefly mentioned