{"id":31515,"date":"2026-11-12T04:53:00","date_gmt":"2026-11-11T20:53:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=31515"},"modified":"2026-11-12T05:52:12","modified_gmt":"2026-11-11T21:52:12","slug":"intensive-care-medicine%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8e%a5%e5%8f%97%e6%8b%a9%e6%9c%9f%e8%85%b9%e9%83%a8%e5%a4%a7%e6%89%8b%e6%9c%af%e7%9a%84%e9%ab%98%e8%a1%80%e5%8e%8b%e9%ab%98","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=31515","title":{"rendered":"[Intensive Care Medicine\u53d1\u8868\u8bba\u6587]\uff1a\u63a5\u53d7\u62e9\u671f\u8179\u90e8\u5927\u624b\u672f\u7684\u9ad8\u8840\u538b\u9ad8\u5371\u60a3\u8005\u7684\u9ad8\u8840\u538b\u4e0e\u6807\u51c6\u8840\u538b\u76ee\u6807"},"content":{"rendered":"\n
Article<\/p>\n\n\n\n
HIgh versus STAndard blood Pressure target in hypertensive high-risk patients undergoing elective major abdominal surgery: the HISTAP multicenter randomized clinical trial<\/h1>\n\n\n\n
Cecconi, M., Cortegiani, A., Noto, A.\u00a0et al<\/em><\/h3>\n\n\n\n
Intensive Care Med<\/em>\u00a052<\/strong>, 1619\u20131634 (2026)<\/h3>\n\n\n\n
The optimal mean arterial pressure (MAP) target in high-risk hypertensive patients undergoing major abdominal surgery remains unclear. The HISTAP trial evaluated whether targeting an intraoperative MAP\u2009\u2265\u200980 compared with\u2009\u2265\u200965 mmHg reduces postoperative organ dysfunction and 30-day mortality, in this population.<\/p>\n\n\n\n
Methods<\/h3>\n\n\n\n
HISTAP was a multicenter, randomized trial conducted at 18 Italian centers between March 2023 and April 2025. The study included patients aged\u2009\u2265\u200960 years with chronic hypertension requiring home therapy, undergoing elective major abdominal surgery and having at least one additional high-risk criterion. The intraoperative MAP was targeted to\u2009\u2265\u200980 mmHg (Treatment group) or\u2009\u2265\u200965 mmHg (Control group). The primary outcome was a composite endpoint including postoperative mortality and at least one major organ dysfunction.<\/p>\n\n\n\n
Findings<\/h3>\n\n\n\n
Of 636 randomized patients, 6 were excluded since surgery was canceled after randomization, 630 completed the trial and were included in the intention-to-treat analysis (median age, 74\u00a0years [IQR, 69\u201379]). Mean intraoperative MAP was 77\u2009\u00b1\u20097\u00a0mmHg in the Control group and 88\u2009\u00b1\u20099\u00a0mmHg in the Treatment group. The primary composite outcome occurred in 48.9% of patients in\u00a0the Control group versus 38.1% of\u00a0patients in the Treatment group (relative risk, 0.78; 95% CI 0.65\u20130.93;\u00a0P<\/em>\u2009=\u20090.006). Acute kidney injury was significantly less frequent in the Treatment group (23.5 vs. 33.7%;\u00a0P<\/em>\u2009=\u20090.005).<\/p>\n\n\n\n<\/figure>\n\n\n\n<\/figure>\n\n\n\n<\/figure>\n\n\n\n<\/figure>\n\n\n\n
Interpretation<\/h3>\n\n\n\n
Among hypertensive patients receiving continuous hemodynamic monitoring and protocolized fluid therapy at increased postoperative risk undergoing major abdominal surgery, targeting an intraoperative MAP\u2009\u2265\u200980 mmHg, compared with\u2009\u2265\u200965 mmHg, reduced major organ dysfunction, primarily due to fewer mild-to-moderate acute kidney injuries.<\/p>\n\n\n\n
Trial registration<\/h3>\n\n\n\n
The HISTAP trial has been registered at ClinicalTrials.gov, NCT05637606 (Date of registration: 24 November 2022).<\/p>\n","protected":false},"excerpt":{"rendered":"
Article HIgh versus STAndard blood Pressure target in h […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31515"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31515"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31515\/revisions"}],"predecessor-version":[{"id":31516,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31515\/revisions\/31516"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31515"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31515"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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