Table 1 Specific causes and remedies for perioperative hypotension

 Hypovolemia

Replace volume depletion with fluids according to the current guidelines or local protocol, minimize starvation if possible [28,29,30].

 ACE-Is/ARBs

Suspend medications in the perioperative period [31,32,33,34].

 Excessive depth of anesthesia

Minimize excessive anesthesia intensity by monitoring the depth of the anesthetic plane [40, 41].

 Neuraxial blockade

Administer intravenous fluids, ephedrine, phenylephrine, ondansetron, leg compression [39].

 Blood loss

Replace volume depletion with fluids and blood products according to the current guidelines or local protocol [42].

 Myocardial ischemia

Hemodynamic and biohumoral markers assessment [31], intraoperative TEE to detect and confirm alteration in myocardial contractility [43].

 Myocardial ischemia

Appropriate hemodynamic and biohumoral markers assessment [31].

 Hypovolemia

Replace volume depletion with fluids and blood products according to the current guidelines or local protocol

 Arrhythmias

Monitor ECG and correct arrythmia using ACLS, ALS or analogue protocols [31, 44, 45].

 Dynamic LVOT Obstruction

Administer fluids, give medications to lower heart rate (e.g beta blockers), stop beta agonists [46, 47].

 Pneumothorax

Treatment as needed (ranges from tight follow-up to chest tube insertion to thoracic surgery) [48].

 Tamponade

Drainage of the pericardial space [49].

 Pulmonary embolism

Treatment according to the guidelines or local protocols [50].

 Sepsis

Treatment according to the Surviving Sepsis Guidelines [51].

 Bleeding

Replace volume depletion, monitor coagulation and correct shortage of coagulation determinants if possible, according to the current protocols [42, 52]