The CAREFUL Study
Research type
Research Study
Full title
Continuous ARterial monitoring in Elderly and Frail patients for hip fractUre surgery to prevent Low blood pressure: The CAREFUL Study
IRAS ID
351284
Contact name
Andrew Kane
Contact email
Sponsor organisation
South Tees Hospitals NHS Foundation Trust
Duration of Study in the UK
2 years, 6 months, 0 days
Research summary
Does measuring blood pressure continuously during surgery benefit patients?
Most patients experience low blood pressure during surgery, which can harm their heart, kidneys or brain, particularly in older patients who may also be frail (e.g. need support in everyday activities). This may affect their long-term health and well-being.
We may be able to prevent low blood pressure by measuring blood pressure every beat rather than the usual practice of every 5 minutes during surgery.
Patients who have broken their hip are at very high risk of complications during and after surgery, as many are older and frail. We know that only 1 in 10 of these patients receive beat-to-beat monitoring. This means 90% may be missing out on a treatment which could benefit them. However, there is limited research supporting this approach.
Three work streams will inform if a large-scale trial is needed and possible.
1: We will review current research in this area and publish a summary of our findings.
2: We will ask clinical teams about their current practice using a survey and focus groups. We will aim to understand what may help or stop them from changing to continuous blood pressure monitoring in patients who may benefit.
3: We will recruit 100 patients over 65 years old living with frailty and needing surgery for a broken hip into a preliminary study. Patients will receive beat-to-beat or usual (intermittent) measurements during surgery. We will assess how practical the study is, record blood pressure measurements during surgery, complications and ask patients about their well-being.
The study was developed with the Royal College of Anaesthetists PPI group and local focus groups. The need for this study was identified within a national RCoA project. PPI representation, including those with lived experience, will be fully embedded in all research areas.
REC name
Wales REC 7
REC reference
25/WA/0235
Date of REC Opinion
15 Sep 2025
REC opinion
Further Information Favourable Opinion