Seeing more papers arguing that both absolute MAP <65 mmHg and relative drops >20% from baseline track with AKI and MINS, and a pooled analysis suggesting risk scales with cumulative hypotension minutes. For those who’ve changed practice, are you targeting closer to baseline or starting low-dose vasopressors earlier (e.g., norepinephrine at induction), and have you noticed fewer post-op creatinine bumps?
And , been there — ETCO2 sitting at 38 while the SpO2 shrieks — > the sky is falling. Moved the clip from a drooly tongue to the lip and it — same here; I dry the site with a 4x4 and cover the probe with a dark towel to kill ambient light, which usually stops the fake desats. If the lip’s unreliable, warm the ear pinna for a minute and clip there, or sanity-check perfusion with a quick Doppler before touching the iso.
I taught my dog a doorbell routine: five minutes before guests arrive, I cue “bed,” close a baby gate, flip on white noise, and scatter a small handful of kibble in the safe room so he’s busy before the first knock. It cut the first-bark chain a lot; if food winds your dog up, swap the scatter for a frozen lick mat and have guests text instead of ringing. Nice calm-zone primer here: https://www.fearfreehappyhomes.com.
I’ve started a norepi infusion at induction (0.02–[redacted]/kg/min) and target within about 10% of the ward MAP for the first 15 minutes; if the preop cuff looks “white coat,” I use the overnight average instead — preempting that early dip has cut my hypotension minutes a lot. @m_jones91 do you anchor to % drop or an absolute like 65?
, door greetings spin my dog up, but hanging a cheap tension‑rod curtain across the hallway to block line of sight plus pairing your hourly 10‑minute break with a calm “settle” cue and a stuffed Toppl cut the barking fast. If the snuffle mat winds them up, swap to long‑lick stuff in a closed‑off room, and @drewfisher99 is right about pre‑arrival routines — two minutes on leash at first contact stops the door rush without more stress.
1 Like