Enhancing Patient Safety with Continuous Blood Pressure Monitoring

A Campaign to Reduce Surgical Harm from Intraoperative Hypotension (IOH)

Capitol Hill Briefing: Enhancing Patient Safety with Continuous Blood Pressure Monitoring
YouTube video

Watch the livestream of the Tuesday, June 10, 2025 briefing on Capitol Hill with Members of Congress, healthcare professionals, and patient safety advocates discussing the urgent need to safeguard patients through Continuous Blood Pressure Monitoring during surgery. This bipartisan panel highlights the public health and patient safety implications of dangerously low blood pressure (hypotension) and the need for an updated standard of care for blood pressure monitoring.

Questions? Please contact Stacey Maxwell, APSF Administrator ([email protected])

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Continuous Blood Pressure Monitoring Sponsors

Continuous Blood Pressure Monitoring at BedsideWhy This Matters

Each year, 1 in 9 people in the U.S. undergo a surgical procedure. Alarmingly, 88% of those patients experience some level of low blood pressure (hypotension) during surgery. Intraoperative Hypotension (IOH) is associated with serious complications such as:

  • Kidney injury
  • Heart damage
  • Stroke
  • Longer hospital stays
  • Mortality

Yet, these risks can be mitigated through timely detection and intervention.

Blood Pressure Monitor During SurgeryProblem: Standard Monitoring Misses Critical Moments

Today, intermittent oscillometric blood pressure arm cuffs are the minimal standard for monitoring during surgery. These cuffs measure blood pressure every few minutes—but they frequently miss rapid drops in blood pressure, regardless of patient or procedure risk.

Studies show:

  • One third of patients experience more than 15 minutes of dangerously low blood pressure
  • It is more common in younger, healthier patients undergoing “routine” procedures
  • Arm cuffs can misclassify up to 50% of hypotensive readings as normal, putting patients at unrecognized risk

Blood Pressure Monitoring During Cesarean DeliveryMaternal Health Implications

The risks of IOH extend to maternal health, particularly during cesarean deliveries, where rapid drops in blood pressure are common and dangerous.

Key concerns:

  • Low blood pressure (hypotension) during and after cesarean delivery can signal serious issues like hemorrhage or sepsis
  • Maternal hypotension during c-section can lead to nausea, vomiting, unconsciousness, and poor placental perfusion – which can put the baby at risk
  • For newborns, it can result in fetal acidosis and poor neurological function, due to reduced oxygen delivery
  • Obstetric anesthesiologists increasingly recognize the need for continuous monitoring to stabilize maternal hemodynamics and improve safety for both mother and baby

Continuous blood pressure monitoring provides real-time data that enables clinicians to respond immediately to hypotensive events, rather than waiting for the next intermittent cuff reading. Eliminating these blind spots between readings enhances patient safety during surgery.

Anesthesiologist Monitoring Blood PressureSolution: Continuous Blood Pressure Monitoring

Traditional continuous blood pressure monitoring provides benefits; however, it requires invasive arterial lines which carry inherent risk. Technological advances in continuous blood pressure monitoring, such as non-invasive finger-cuffs provide real-time measurement of blood pressure, alerting clinicians to drops immediately—reducing the risk of patient harm.

Proven benefits:

  • Detects hypotension earlier
  • Reduces severity and duration of IOH
  • Minimizes need for invasive arterial lines
  • Shown to be as accurate as invasive methods in clinical trials

Expert Medical Society SupportExpert & Medical Society Support:

  • Anesthesia Patient Safety Foundation (APSF) recommends accelerating the adoption and integration of continuous non-invasive monitoring
  • The Perioperative Quality Initiative (POQI) concludes that there is high quality evidence that continuous blood pressure monitoring helps reduce the severity and duration of hypotension compared to intermittent monitoring
  • The German Society of Anesthesiology and Intensive Care Medicine recommends that continuous blood pressure monitoring, via invasive or non-invasive methods, should be used in patients at risk of blood pressure-related complications to enable real-time detection and management of hypotension or hypertension.

Operating Room MonitoringSummary: Why We Must Act Now

  1. IOH is common—even in low-risk surgeries
  2. IOH increases the risk of serious complications
  3. Intermittent cuff monitoring may miss IOH
  4. Continuous non-invasive monitoring has been shown to reduce IOH and enhance patient safety

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