Haemodynamics during surgery: patient’s blood pressure management and optimisation

The current thesis contributes to blood pressure management during surgery, investigating hypotension prevention and recovery in a data-driven way. For the prevention of hypotension, a randomised controlled trial was conducted comparing the hypotension prediction index with an elevated mean arterial pressure alarm. Hereby, it was found that a mean arterial pressure alarm could effectively substitute the hypotension prediction index. In addition, research was conducted on choosing the appropriate intervention to solve hypotension, choosing between preload, afterload and cardiac contractility. For this research, treatment advice from an existing device was evaluated and an in-depth waveform analysis was performed, including arterial blood pressure and photoplethysmography curves. Further research on personalised MAP thresholds and ways to measure perfusion objectively and quantitatively during surgery could contribute to the goal of delivering effective personalised care.