This piece focuses upon the Hypotension Predictive Index (HPI) technology. We look at the validation process of HPI, addressing criticisms and clarifying its predictive ability for hemodynamic instability. How important is it to understand the underlying causes of instability rather than solely relying on blood pressure readings? What is the role of HPI in early detection and proactive management? The discussion also touches on the limitations of traditional mean arterial pressure (MAP) monitoring and the need for a holistic approach to hemodynamic assessment.

Presented by Desiree Chappell, TopMedTalk's co-editor in Chief, speaking with Monty Mythen, Senior Vice President Medical Affairs, Edwards Lifesciences, Critical Care, Emeritus Professor of Anaesthesia and Critical Care, University College London, Thomas Sheeran, Senior Director Medical Affairs, Edwards Lifesciences, and Simon Davies, Consultant Anaesthetist at York Teaching Hospital NHS Foundation Trust.

The paper 'Comparison of Differences in Cohort (Forward) and Case Control (Backward) Methodological Approaches for Validation of the Hypotension Prediction Index' is here: https://pubs.asahq.org/anesthesiology/article/doi/10.1097/ALN.0000000000004989/139987/Comparison-of-Differences-in-Cohort-Forward-and?searchresult=1

Here's the link to the Physiology Lab section of last year's ASA symposium on YouTube: https://youtu.be/yfl1VMMgIRs?si=YxGfOs-pdlIVVGt1

Here are publications relating HPI to hemodynamic instability at a microcirculation level:

https://pubmed.ncbi.nlm.nih.gov/33755645/

https://pubmed.ncbi.nlm.nih.gov/36335548/