In this episode of Updates in Anesthesiology, Dr. Hadzic unpacks a major 2025 multicenter trial by Dr. Javier Ripollés-Melchor and colleagues, exploring whether the Hypotension Prediction Index (HPI) can actually reduce postoperative acute kidney injury (AKI) in abdominal surgery. Despite HPI’s promise in predicting intraoperative hypotension, the trial found no reduction in AKI or overall complications compared to standard care. We break down what this means for your practice, how vasopressor choice might matter more than prediction tools, and why clinical judgment still reigns supreme in the OR. Stay tuned for the key takeaways and what to do with that HPI alert next time it flashes on your monitor.

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