{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T06:33:02Z","timestamp":1766212382552,"version":"3.48.0"},"reference-count":14,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"crossref","award":["JP22hk0102081"],"award-info":[{"award-number":["JP22hk0102081"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study aimed to develop and evaluate an automated fluid infusion management system for preventing hypotension during general anesthesia. Methods: This study was a single-blind, randomized, non-inferiority, clinical trial. Seventy-nine patients undergoing surgery under general anesthesia were randomly assigned to either an automatic group or a manual group. In the automatic group, the infusion rate was automatically adjusted based on stroke volume (SV) and effective arterial elastance (Ea), whereas in the manual group, the attending anesthesiologist manually adjusted the infusion rate according to the Enhanced Recovery After Surgery (ERAS) protocol. The primary endpoint was the proportion of time during anesthesia that mean arterial pressure (Pm) was maintained at \u226565 mmHg. Secondary endpoints included the proportion of time the estimated stroke volume index (esSVI) was below the threshold, total fluid volume administered, total phenylephrine dose, urine output, blood loss, and average estimated stroke volume variation (esSVV). Results: The results demonstrated non-inferiority of the automatic group to the manual group in maintaining Pm \u2265 65 mmHg (automatic group: 82.0 \u00b1 12.7%, manual group: 79.9 \u00b1 15.7%; difference [automatic group\u2212manual group]: 2.0 percentage points; one-sided 97.5% CI lower limit: \u22124.7%; non-inferiority margin: \u22125%). There were no significant differences between the groups in total fluid volume, phenylephrine dose, urine output, or blood loss. No severe adverse events or device-related adverse events were observed. Conclusions: The automated system maintained intraoperative blood pressure safely and effectively.<\/jats:p>","DOI":"10.3390\/jcm14248952","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T13:45:07Z","timestamp":1766065507000},"page":"8952","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Development of an Automated Fluid Infusion Management System to Prevent Hypotension During General Anesthesia: A Randomized Clinical Trial"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2949-2574","authenticated-orcid":false,"given":"Yuka","family":"Matsuki","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimatology, University of Fukui Hospital, Fukui 910000, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4107-4156","authenticated-orcid":false,"given":"Yukie","family":"Mizuta","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 819000, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-0015","authenticated-orcid":false,"given":"Shuko","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimatology, University of Fukui Hospital, Fukui 910000, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koyo","family":"Nishio","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimatology, University of Fukui Hospital, Fukui 910000, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1860-0747","authenticated-orcid":false,"given":"Midoriko","family":"Higashi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 819000, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9392-1746","authenticated-orcid":false,"given":"Ken","family":"Yamaura","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 819000, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3281-4477","authenticated-orcid":false,"given":"Kenji","family":"Shigemi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimatology, University of Fukui Hospital, Fukui 910000, Japan"},{"name":"Maizuru Municipal Hospital, Kyoto 624000, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/j.bja.2018.04.036","article-title":"Intraoperative hypotension and the risk of postoperative adverse outcomes: A systematic review","volume":"121","author":"Wesselink","year":"2018","journal-title":"Br. 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