The Hypotension Prediction Index did not beat a simple MAP trigger of 73 mmHg

The edition in brief

In a two-centre open-label trial of 100 adults having major noncardiac surgery with arterial lines, treating when the Hypotension Prediction Index reached 85 was not superior to treating when mean arterial pressure fell to 73 mmHg: time-weighted hypotension was 0.07 versus 0.16 mmHg (P = 0.12), with no difference in vasopressor dose, stay or mortality. The trial was not designed to show equivalence. In 185,455 French surgical patients, each 5 mmHg fall in mean end-tidal CO₂ below the median was associated with higher in-hospital mortality (aOR 1.63), independent of hypotension and minute ventilation. The FDA lists a Class II recall of a US-distributed fentanyl citrate infusion bag for an expiry-date labelling discrepancy. In 258,624 Ontario arthroplasty patients, filling a new extended-release opioid prescription was associated with slightly more persistent opioid use (aOR 1.08) and emergency visits. In 676,641 anaesthetics, hoarseness needing ENT referral occurred in about 1.5 per 1,000, most strongly linked to nasogastric tubes.