{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:55:29Z","timestamp":1790888129568,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T00:00:00Z","timestamp":1537315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In free flap head and neck reconstructions, hemodynamic management is complicated by the deleterious effects of excessive crystalloid administration. Patients may undergo periods of hypotension or excess fluid administration. The purpose of this study was to present our examination of the hypotheses that intraoperative hypotension and blood pressure lability are associated with increased fluid administration and flap failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the records of 445 patients undergoing head and neck surgery involving free tissue transfer. We used multivariate logistic regression to examine the relationship between hemodynamic variables and flap loss (primary outcome) and other complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On multivariate analysis, intraoperative hypotension and large\u2010volume fluid administration were associated with flap loss. Neither blood pressure lability nor vasopressor administration was significantly associated to our primary outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intraoperative hypotension is associated to flap failure in head and neck free tissue transfer surgeries, as is large\u2010volume fluid administration.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.25190","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T12:23:20Z","timestamp":1537359800000},"page":"2334-2339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Intraoperative hypotension and flap loss in free tissue transfer surgery of the head and neck"],"prefix":"10.1002","volume":"40","author":[{"given":"Jason L.","family":"Kass","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Dana Farber Cancer Institute Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-3788","authenticated-orcid":false,"given":"Sameer","family":"Lakha","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Levin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative and Pain Medicine Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Mo","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Genden","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Division of Head and Neck Oncology Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marita S.","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Division of Head and Neck Oncology Icahn School of Medicine at Mount Sinai New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett A.","family":"Miles","sequence":"additional","affiliation":[{"name":"Department of 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use of vasopressors does not increase the risk of free flap compromise and failure in cancer patients","author":"Fang L","year":"2017","journal-title":"Ann Surg."},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31825dbf73"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002176"}],"container-title":["Head &amp; 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