{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:43:52Z","timestamp":1789393432593,"version":"build-2803163510"},"reference-count":34,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81770298"],"award-info":[{"award-number":["81770298"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Anesthesia"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.jclinane.2025.111978","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T08:00:23Z","timestamp":1758700823000},"page":"111978","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"special_numbering":"C","title":["Anti-inflammatory and anti-nociceptive effects of individualized blood pressure strategy based on low-dose noradrenaline infusion in elderly patients following major surgery: A randomized, controlled study"],"prefix":"10.1016","volume":"107","author":[{"given":"Zheng","family":"Fang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-jie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-he","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-hui","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwei","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-qi","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jclinane.2025.111978_bb0005","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/SLA.0000000000001691","article-title":"Inflammatory and immune responses to surgery and their clinical impact","volume":"264","author":"Alazawi","year":"2016","journal-title":"Ann Surg"},{"issue":"11","key":"10.1016\/j.jclinane.2025.111978_bb0010","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1111\/anae.16104","article-title":"Postoperative systemic inflammation after major abdominal surgery: patient-centred outcomes. RELIEF trial investigators","volume":"78","author":"Bain","year":"2023","journal-title":"Anaesthesia"},{"issue":"1","key":"10.1016\/j.jclinane.2025.111978_bb0015","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1186\/s12882-018-1073-4","article-title":"Neutrophil, lymphocyte and platelet ratio as a predictor of postoperative acute kidney injury in major abdominal surgery","volume":"19","author":"Gameiro","year":"2018","journal-title":"BMC Nephrol"},{"issue":"7","key":"10.1016\/j.jclinane.2025.111978_bb0020","doi-asserted-by":"crossref","first-page":"326","DOI":"10.4240\/wjgs.v12.i7.326","article-title":"Neutrophil-to-lymphocyte ratio predicts acute kidney injury occurrence after gastrointestinal and hepatobiliary surgery","volume":"12","author":"Bi","year":"2020","journal-title":"World J Gastrointest Surg"},{"issue":"1","key":"10.1016\/j.jclinane.2025.111978_bb0025","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s12882-024-03526-w","article-title":"Systemic inflammation and acute kidney injury after colorectal surgery","volume":"25","author":"Mannion","year":"2024","journal-title":"BMC Nephrol"},{"issue":"4","key":"10.1016\/j.jclinane.2025.111978_bb0030","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s00134-015-4157-7","article-title":"Incidence and associations of acute kidney injury after major abdominal surgery","volume":"42","author":"O\u2019Connor","year":"2016","journal-title":"Intensive Care Med"},{"issue":"10","key":"10.1016\/j.jclinane.2025.111978_bb0035","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1080\/03007995.2018.1459527","article-title":"Acute kidney injury after non-cardiovascular surgery: risk factors and impact on development of chronic kidney disease and long-term mortality","volume":"34","author":"Pourafkari","year":"2018","journal-title":"Curr Med Res Opin"},{"issue":"3","key":"10.1016\/j.jclinane.2025.111978_bb0040","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1177\/0885066610396312","article-title":"Norepinephrine or dopamine for septic shock: systematic review of randomized clinical trials","volume":"27","author":"Vasu","year":"2012","journal-title":"J Intensive Care Med"},{"issue":"5","key":"10.1016\/j.jclinane.2025.111978_bb0045","doi-asserted-by":"crossref","first-page":"374","DOI":"10.2460\/ajvr.82.5.374","article-title":"In vitro effects of epinephrine, norepinephrine, and dobutamine on lipopolysaccharide-stimulated production of tumor necrosis factor-alpha, interleukin-6, and interleukin-10 in blood from healthy dogs","volume":"82","author":"Merrill","year":"2021","journal-title":"Am J Vet Res"},{"issue":"3","key":"10.1016\/j.jclinane.2025.111978_bb0050","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/j.1600-0625.2007.00677.x","article-title":"Norepinephrine modulates human dendritic cell activation by altering cytokine release","volume":"17","author":"Goyarts","year":"2008","journal-title":"Exp Dermatol"},{"issue":"6","key":"10.1016\/j.jclinane.2025.111978_bb0055","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1164\/rccm.202002-0339OC","article-title":"Norepinephrine dysregulates the immune response and compromises host defense during sepsis","volume":"202","author":"Stolk","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"issue":"9","key":"10.1016\/j.jclinane.2025.111978_bb0060","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1097\/EJA.0000000000001046","article-title":"Complex effects of continuous vasopressor infusion on fluid responsiveness during liver resection: a randomised controlled trial","volume":"36","author":"Nakamoto","year":"2019","journal-title":"Eur J Anaesthesiol"},{"issue":"1","key":"10.1016\/j.jclinane.2025.111978_bb0065","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s00134-009-1687-x","article-title":"The effects of vasopressin on acute kidney injury in septic shock","volume":"36","author":"Gordon","year":"2010","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jclinane.2025.111978_bb0070","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1213\/ANE.0000000000001323","article-title":"Acute kidney injury after abdominal surgery: incidence, risk factors, and outcome","volume":"122","author":"Long","year":"2016","journal-title":"Anesth Analg"},{"key":"10.1016\/j.jclinane.2025.111978_bb0075","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jclinane.2017.09.004","article-title":"Optimal blood pressure decreases acute kidney injury after gastrointestinal surgery in elderly hypertensive patients: a randomized study: optimal blood pressure reduces acute kidney injury","volume":"43","author":"Wu","year":"2017","journal-title":"J Clin Anesth"},{"key":"10.1016\/j.jclinane.2025.111978_bb0080","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.amjsurg.2024.02.001","article-title":"Intraoperative hypotension and postoperative acute kidney injury: a systematic review","volume":"232","author":"Penev","year":"2024","journal-title":"Am J Surg"},{"issue":"1","key":"10.1016\/j.jclinane.2025.111978_bb0085","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/ALN.0000000000001432","article-title":"Relationship between intraoperative hypotension, defined by either reduction from baseline or absolute thresholds, and acute kidney and myocardial injury after noncardiac surgery: a retrospective cohort analysis","volume":"126","author":"Salmasi","year":"2017","journal-title":"Anesthesiology"},{"issue":"3","key":"10.1016\/j.jclinane.2025.111978_bb0090","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/ALN.0000000000003063","article-title":"Preoperative risk and the association between hypotension and postoperative acute kidney injury","volume":"132","author":"Mathis","year":"2020","journal-title":"Anesthesiology"},{"issue":"14","key":"10.1016\/j.jclinane.2025.111978_bb0095","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1001\/jama.2017.14172","article-title":"Effect of individualized vs standard blood pressure management strategies on postoperative organ dysfunction among high-risk patients undergoing major surgery: a randomized clinical trial","volume":"318","author":"Futier","year":"2017","journal-title":"JAMA"},{"issue":"5","key":"10.1016\/j.jclinane.2025.111978_bb0100","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.bja.2023.02.004","article-title":"Norepinephrine versus phenylephrine for treating hypotension during general anaesthesia in adult patients undergoing major noncardiac surgery: a multicentre, open-label, cluster-randomised, crossover, feasibility, and pilot trial","volume":"130","author":"Legrand","year":"2023","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.jclinane.2025.111978_bb0105","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/ALN.0000000000000463","article-title":"Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management","volume":"122","author":"American Society of Anesthesiologists Task Force on Perioperative Blood Management","year":"2015","journal-title":"Anesthesiology"},{"issue":"9847","key":"10.1016\/j.jclinane.2025.111978_bb0110","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/S0140-6736(12)61148-9","article-title":"Mortality after surgery in Europe: a 7 day cohort study","volume":"380","author":"Pearse","year":"2012","journal-title":"Lancet"},{"key":"10.1016\/j.jclinane.2025.111978_bb0115","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/bja\/85.1.109","article-title":"The stress response to trauma and surgery","volume":"85","author":"Desborough","year":"2000","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.jclinane.2025.111978_bb0120","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/00000542-199209000-00004","article-title":"Responses of plasma adrenocorticotropic hormone, cortisol, and cytokines during and after upper abdominal surgery","volume":"77","author":"Naito","year":"1992","journal-title":"Anesthesiology"},{"key":"10.1016\/j.jclinane.2025.111978_bb0125","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2023.1271098","article-title":"Impact of norepinephrine on immunity and oxidative metabolism in sepsis","volume":"14","author":"Thoppil","year":"2023","journal-title":"Front Immunol"},{"issue":"3","key":"10.1016\/j.jclinane.2025.111978_bb0130","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1007\/s12630-017-1045-3","article-title":"The physiologic basis for goal-directed hemodynamic and fluid therapy: the pivotal role of the venous circulation","volume":"65","author":"Gelman","year":"2018","journal-title":"Can J Anaesth"},{"issue":"1","key":"10.1016\/j.jclinane.2025.111978_bb0135","doi-asserted-by":"crossref","first-page":"35","DOI":"10.2215\/CJN.06620619","article-title":"Intraoperative arterial pressure variability and postoperative acute kidney injury","volume":"15","author":"Park","year":"2020","journal-title":"Clin J Am Soc Nephrol"},{"issue":"3","key":"10.1016\/j.jclinane.2025.111978_bb0140","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.bja.2022.05.002","article-title":"Fluids, vasopressors, and acute kidney injury after major abdominal surgery between 2015 and 2019: a multicentre retrospective analysis","volume":"129","author":"Chiu","year":"2022","journal-title":"Br J Anaesth"},{"issue":"1","key":"10.1016\/j.jclinane.2025.111978_bb0145","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s12871-018-0564-y","article-title":"Effects of perioperative goal-directed fluid therapy combined with the application of alpha-1 adrenergic agonists on postoperative outcomes: a systematic review and meta-analysis","volume":"18","author":"Feng","year":"2018","journal-title":"BMC Anesthesiol"},{"issue":"1","key":"10.1016\/j.jclinane.2025.111978_bb0150","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1080\/0886022X.2022.2072338","article-title":"Effect of goal-directed fluid therapy on renal function in critically ill patients: a systematic review and meta-analysis","volume":"44","author":"Zhao","year":"2022","journal-title":"Ren Fail"},{"issue":"6","key":"10.1016\/j.jclinane.2025.111978_bb0155","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1016\/j.athoracsur.2022.03.070","article-title":"Goal-directed fluid therapy does not have an impact on renal outcomes in an enhanced recovery program","volume":"114","author":"Zorrilla-Vaca","year":"2022","journal-title":"Ann Thorac Surg"},{"issue":"24","key":"10.1016\/j.jclinane.2025.111978_bb0160","first-page":"e278","article-title":"2014ACC\/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing non-cardiac surgery: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"130","author":"Fleisher","year":"2014","journal-title":"Circulation"},{"key":"10.1016\/j.jclinane.2025.111978_bb0165","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1097\/ALN.0b013e3182a44440","article-title":"Restrictive deferred hydration combined with preemptive norepinephrine infusion during radical cystectomy reduces postoperative complications and hospitalization time. A randomized clinical trial","volume":"120","author":"Wuethrich","year":"2014","journal-title":"Anesthesiology"},{"issue":"5","key":"10.1016\/j.jclinane.2025.111978_bb0170","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1213\/ANE.0000000000001239","article-title":"Should norepinephrine, rather than phenylephrine, be considered the primary vasopressor in anesthetic practice?","volume":"122","author":"Mets","year":"2016","journal-title":"Anesth Analg"}],"container-title":["Journal of Clinical Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0952818025002399?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0952818025002399?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T08:01:15Z","timestamp":1764835275000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0952818025002399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":34,"alternative-id":["S0952818025002399"],"URL":"https:\/\/doi.org\/10.1016\/j.jclinane.2025.111978","relation":{},"ISSN":["0952-8180"],"issn-type":[{"value":"0952-8180","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Anti-inflammatory and anti-nociceptive effects of individualized blood pressure strategy based on low-dose noradrenaline infusion in elderly patients following major surgery: A randomized, controlled study","name":"articletitle","label":"Article Title"},{"value":"Journal of Clinical Anesthesia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jclinane.2025.111978","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"111978"}}