{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:54:48Z","timestamp":1791834888611,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 112\u20102314\u2010B\u2010002\u2010118"],"award-info":[{"award-number":["NSTC 112\u20102314\u2010B\u2010002\u2010118"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intra\u2010operative hypotension is common during caesarean section and may result in adverse maternal effects, such as nausea and vomiting. While oscillometric blood pressure and continuous non\u2010invasive arterial pressure monitoring enable reactive treatment, the hypotension prediction index offers a machine learning\u2010based approach that may allow proactive haemodynamic intervention. This study investigated whether hypotension prediction index\u2010guided management could reduce the incidence of intra\u2010operative hypotension compared with oscillometric and continuous non\u2010invasive arterial pressure monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients scheduled for elective caesarean section under spinal anaesthesia were allocated randomly to one of three haemodynamic monitoring strategies: oscillometric blood pressure; continuous non\u2010invasive arterial pressure; or hypotension prediction index\u2010guided monitoring. Hypotension and hypertension were defined as mean arterial pressure &lt;\u200965\u2009mmHg and \u2265\u2009100\u2009mmHg, respectively. Hypotension was treated using intermittent intravenous boluses of noradrenaline. The primary outcome was the time\u2010weighted average of hypotension. Secondary outcomes included time\u2010weighted average hypertension and maternal adverse effects, including bradycardia, nausea and vomiting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 171 patients were analysed. Median time\u2010weighted average hypotension was significantly higher in patients allocated to the oscillometric and continuous non\u2010invasive arterial pressure groups compared with the hypotension prediction index group (0.89\u2009mmHg and 0.30\u2009mmHg vs. 0.08\u2009mmHg, respectively, p\u2009&lt;\u20090.001). Patients allocated to the oscillometric group had a higher incidence of maternal nausea and vomiting compared with those allocated to the continuous non\u2010invasive arterial pressure and hypotension prediction index groups (nausea: 43\/59 vs. 29\/55 and 30\/57, respectively, p\u2009=\u20090.038; and vomiting: 13\/59 vs. 6\/55 and 3\/57, respectively, p\u2009=\u20090.023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Hypotension prediction index\u2010guided management during caesarean section significantly reduced intra\u2010operative hypotension without increasing the risk of hypertension. This approach provides a proactive strategy for haemodynamic optimisation in obstetric anaesthesia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70161","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:53:26Z","timestamp":1771228406000},"page":"924-932","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Proactive haemodynamic management using the hypotension prediction index during caesarean section: a randomised controlled study"],"prefix":"10.1111","volume":"81","author":[{"given":"Po\u2010Yuan","family":"Shih","sequence":"first","affiliation":[{"name":"Department of Anesthesiology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu\u2010Jung","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen\u2010Tse","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Chieh","family":"Shih","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Life Sciences and Medicine National Tsing Hua University  Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010Hsi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yow\u2010Shan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Cathay General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin\u2010Ting","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, National Taiwan University Hospital. 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