• Taufiek Konrad Rajab and Jan Dieter Schmitto.
• Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: trajab@rics.bwh.harvard.edu.
• Med. Hypotheses. 2014 Jul 1; 83 (1): 127-9.

AbstractIntraoperative hypotension is associated with adverse outcomes. The preferred treatment for intraoperative hypotension is to address its cause. In the interim the blood pressure can be supported by the anesthesia team with volume resuscitation and vasopressors. Additionally, preferential perfusion of vital organs, such as the myocardium and cerebrum, at the expense of non-vital vascular beds, such as the extremities, is desirable. In the state of shock, the flight or fight response will ensure perfusion of the extremities in order to prepare the organism for a physical confrontation. However, in the context of intraoperative hypotension this response is counter-productive. Therefore we propose bilateral femoral artery compression as a new technique to increase vital organ perfusion during intraoperative hypotension. This results in shunting of blood flow from the legs and towards the vital organs. Bilateral femoral artery compression can be employed by the surgical team to immediately improve blood pressure until other counter-measures against intraoperative hypotension take effect.Copyright © 2014 Elsevier Ltd. All rights reserved.

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