Current Practice Patterns and Considerations for Invasive Blood Pressure Monitoring in Elective Noncardiac Surgery: Results of the American Society of Anesthesiologists Member Survey.

OBJECTIVES

To evaluate current clinical practices among anesthesiologists in the United States regarding decision-making for invasive blood pressure (IBP) monitoring in elective noncardiac surgery.

DESIGN

Multiple-choice survey assessing indications for IBP monitoring.

SETTING

Online survey administered using the REDCap platform.

PARTICIPANTS

Members of the American Society of Anesthesiologists.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN

RESULTS

Of 26,986 surveys distributed, 1,268 respondents completed the survey in full. Among patient-related factors, medical history (97.8%; 1,241 of 1,268) and left ventricular ejection fraction (93.6%; 1,187 of 1,268) were most frequently rated as important or very important when considering IBP monitoring, followed by Revised Cardiac Risk Index (RCRI) score (70.9%; 900 of 1,268) and age (38.2%; 484 of 1,268). Most respondents reported being likely or very likely to place an arterial catheter in patients with an RCRI score of 3 (77.2%; 979 of 1,268). Among surgical factors, procedure type (99.4%; 1,260 of 1,268) and anticipated blood loss (96.6%; 1,225 of 1,268) were most commonly rated as important or very important. Notably, nontraditional factors, including prior experience with the surgeon (81%; 1,027 of 1,268), estimated case duration (78.1%; 991 of 1,268), and patient positioning (76.7%; 973 of 1,268), were also frequently considered important or very important.

CONCLUSION

Results of this survey showed that decision-making regarding IBP monitoring in elective noncardiac surgery extends beyond traditional patient- and procedure-related risk factors. Anesthesiologists commonly consider nontraditional indications, such as prior experience with the surgeon, patient positioning, and expected case duration, highlighting the multifactorial and nuanced nature of clinical judgment regarding IBP monitoring.