ImPortance of Arterial Measurement Sites (IPAMS) on Intraoperative Hemodynamic Management

Launched by CIUSSS DE L'EST DE L'ÎLE DE MONTRÉAL · May 13, 2025

Keywords

ClinConnect Summary

This clinical trial, called IPAMS, is studying how the location where blood pressure is measured affects patient care during major abdominal surgeries. Specifically, it compares two methods: one that measures blood pressure from the radial artery in the wrist, which is the standard approach, and another that measures it from the brachial artery in the arm, which might give a more accurate reading of central blood pressure. The researchers want to find out if using the brachial artery impacts the amount of medications (called vasopressors) needed during surgery, as well as how reliable these different measurement sites are.

To participate in this trial, patients need to be between 18 and 90 years old and scheduled for major abdominal surgery lasting over two hours. They must be able to receive general anesthesia and not have certain medical conditions that would make it unsafe to insert the arterial lines needed for the study. If eligible and consenting, participants will be randomly assigned to one of two groups: one group will use the brachial artery for blood pressure management, while the other will continue with the standard radial artery approach. Both groups will have their anesthesia managed in the same way to keep the study fair. This trial is an opportunity to help improve how blood pressure is monitored during surgeries, potentially leading to better patient outcomes.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients between 18 and 90 years of age;
• • Major abdominal surgery via laparoscopy or laparotomy under general anesthesia - with or without concomitant use of regional or neuraxial anesthesia;
• • Expected anesthesia time of more than 120 minutes.
• Exclusion Criteria:
• • Known peripheral severe vascular disease with subclavian artery stenosis,
• • Significant arterial gradient between arms with preoperative non-invasive bloop pressure measurements (\>25 mm Hg of systolic blood pressure or 10 mm Hg of mean arterial pressure);
• • Inability or contraindications to insert arterial line on either arm (arteriovenous fistula, surgical sterility);
• • Known allergies, intolerance, other medical conditions that precludes the use of prescribed general anesthesia protocol for this trial;
• • Inability to communicate in French or English.