Management of Intraoperative Hypotension: Prediction, Prevention and Personalization

  • T. W. L. ScheerenEmail author
  • B. Saugel
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)


The human cardiovascular system is pressure regulated with relatively high arterial pressures to guarantee organ perfusion. Arterial blood pressure is kept fairly constant, at least in healthy individuals. The system can be compared to a water tower providing a constant pressure head, with changes in local resistance (like opening the water tap), allowing a distribution of flow to the different organs, according to their need. Some organ systems (e.g., the brain and kidneys) regulate blood flow – within certain limits – independently of blood pressure. This phenomenon is called ‘autoregulation of blood flow’ and aims at protecting these organs from hypoperfusion. Below the lower limits of this autoregulation, organ perfusion becomes linearly dependent on blood pressure. Even in some circulatory shock states (hypovolemic shock and cardiogenic shock), blood pressure is kept constant for a long time due to stimulation of the sympathetic nervous system,...


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology, University of GroningenUniversity Medical Center GroningenGroningenNetherlands
  2. 2.Department of Anesthesiology, Center of Anesthesiology and Intensive Care MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany

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