Newsletter 2025
The SQUEEZE Study - a landmark ESAIC-grant sponsored project – is now published in the British Journal of Anaesthesia
Huge variation in Postoperative Vasopressor use
The SQUEEZE study has been published in the British Journal of Anaesthesia. The Study, entirely sponsored by a grant from the European Society of Anaesthesiology and Intensive Care Clinical Trial Network (ESAIC CTN), analysed data from 25,675 patients across 228 hospitals in 42 countries.
Results: An unexpected difference in how vasopressors (blood-pressure supporting medicine) are used after non-cardiac surgery.
Explanation: In some hospitals, only one in 100 patients received vasopressors after surgery, while in other hospitals, as many as one in eight patients received vasopressors after surgery. These variations could not be explained by how ill patients were, the type of surgery performed, or whether the hospital was in a high- or low-income country.
The study suggest that physician preference or local culture decides how patients are treated postoperatively, not the access to resources or medical evidence. When deciding whether to administer vasopressors or not, most doctors rely more on their personal judgement rather than on objective cardiac output monitoring. Although practice varied widely regarding if to give treatment, there was broad consensus on which medication to use, with norepinephrine as the favourite and in line with the literature.
This inconsistency has important implications: Patients undergoing the same operation with similar health profiles may receive very different treatment depending on which hospital they are treated in. This may in the end impact their outcomes.
The SQUEEZE study was conducted during the period of the COVID-19 pandemic and so stands as an example of resilience and dedication of the more than 1,000 investigators who contributed. Their effort has created a unique resource that will shape perioperative medicine for years to come.
The full article is freely available in Open Access at the British Journal of Anaesthesia: Read here
