{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T20:12:52Z","timestamp":1757621572472,"version":"3.44.0"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016220","name":"Georgia Clinical and Translational Science Alliance","doi-asserted-by":"publisher","award":["UL1TR001425"],"award-info":[{"award-number":["UL1TR001425"]}],"id":[{"id":"10.13039\/100016220","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Perioperative management of angiotensin inhibitors is contentious in adults and understudied in children. Perioperative angiotensin inhibitor management in pediatrics cannot be extrapolated from adult literature because of dynamic neurohormonal pediatric physiology and uniquely pediatric indications for angiotensin inhibitor therapy. There is limited evidence for whether angiotensin inhibitors should be held in the perioperative setting in the pediatric population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study is to assess whether perioperative angiotensin inhibitor use is associated with intraoperative hypotension in the pediatric population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single center, retrospective cohort study. Data collection comprised demographics, angiotensin inhibitor dose timing and intraoperative blood pressure. Participants patients were divided into two groups based on recency of dose of angiotensin inhibitor, Recents had angiotensin inhibitor therapy within 2\u2009days and Remotes had angiotensin inhibitor therapy between 2 and 30\u2009days. Logistic regression with covariate adjustment and propensity score matching were performed to control confounding. Regression analysis and Chi\u2010squared test were used to compare the incidence of hypotension between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred ninety patients were included in the study prior to propensity score matching. We found the overall incidence of hypotension to be 29% (142\/490). There was no difference in the incidence of hypotension by recency of angiotensin inhibitor dose between the two groups prior to matching, Recents 25.4% (59\/232), Remotes 32% (83\/258), <jats:italic>p<\/jats:italic>\u2009=\u20090.06. Adjusting for covariates, the odds ratio for hypotension is 0.73 (0.48\u20131.10, <jats:italic>p<\/jats:italic>\u2009=\u20090.129) for Recents compared to Remotes. After propensity score matching, there were 184 patients in each group. There remained no difference in the incidence of hypotension in the between the two groups, Recents 27% (50\/184), Remotes 33% (61\/184), <jats:italic>p<\/jats:italic>\u2009=\u20090.13.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found no evidence to support the practice of abstaining from angiotensin inhibitor use in pediatric surgical patients for concern of intraoperative hypotension.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.70004","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T08:23:36Z","timestamp":1751012616000},"page":"848-855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective Review of Intraoperative Hypotension and Perioperative Angiotensin Inhibitor Use in Pediatrics"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2890-4557","authenticated-orcid":false,"given":"Zhe Amy","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Pediatric Anesthesiology and Pain Medicine, Ann &amp; Robert H. Lurie Children's Hospital of Chicago Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Palmer","sequence":"additional","affiliation":[{"name":"Gordon College  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristie","family":"Geisler","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6292-1564","authenticated-orcid":false,"given":"Abby V.","family":"Winterberg","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Cincinnati Children's Hospital Affiliate Assistant Professor, University of Cincinnati College of Nursing  Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9906-1895","authenticated-orcid":false,"given":"Jamie","family":"Sinton","sequence":"additional","affiliation":[{"name":"Department of Surgery and Perioperative Care Dell Children's Hospital  Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12072611"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.021"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2020.02.052"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201081161\u20103"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14271"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002849"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002837"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2018.00121"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001310"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460\u20109592.2008.02871.x"},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2024","author":"R Core Team","key":"e_1_2_9_13_1"},{"volume-title":"Stata Statistical Software: Release 15","year":"2017","author":"StataCorp","key":"e_1_2_9_14_1"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063\u2010021\u201005992\u20101"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2150135114549748"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.017405"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2013.10.008"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741\u2010019\u201009797\u2010y"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695\u2010015\u20101862\u20109"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.70004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T14:16:08Z","timestamp":1757340968000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.70004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,27]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/pan.70004"],"URL":"https:\/\/doi.org\/10.1111\/pan.70004","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"type":"print","value":"1155-5645"},{"type":"electronic","value":"1460-9592"}],"subject":[],"published":{"date-parts":[[2025,6,27]]},"assertion":[{"value":"2024-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}