Hypotension is a common cause of acute kidney injury (AKI), with strong associations between the duration and magnitude of hypotension seen across a range of situations including major surgery. However, it is less clear whether targeting higher intraoperative MAP results in lower rates of AKI. In a prespecified analysis of the Perioperative Ischemic Evaluation-3 (POISE-3) randomized controlled trial, this question is addressed for noncardiac major surgery. Despite an increase in cessation of antihypertensive medications and higher intraoperative mean arterial blood pressure in the intervention arm, no differences were seen in the rates of postoperative AKI. This commentary discusses the strengths and weaknesses of the trial, as well as providing some interpretation of results and their relevance to clinical practice.

中文翻译：

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较高的术中血压并不能减少非心脏手术中的急性肾损伤：POISE-3 试验的结果告诉我们什么？


低血压是急性肾损伤 （AKI） 的常见原因，在包括大手术在内的一系列情况下，低血压的持续时间和程度之间存在很强的相关性。然而，目前尚不清楚靶向较高的术中 MAP 是否会导致 AKI 发生率降低。在围手术期缺血评估 3 （POISE-3） 随机对照试验的预先指定分析中，这个问题适用于非心脏大手术。尽管干预组的降压药物停止率增加，术中平均动脉血压升高，但术后 AKI 的发生率没有差异。本评论讨论了该试验的优缺点，并对结果及其与临床实践的相关性进行了一些解释。