Perioperative haemodynamic therapy.

Abstract:

PURPOSE OF REVIEW:To discuss the perioperative monitoring tools and targets for haemodynamic optimization and to assess the influence of goal-directed therapy (GDT) on organ function, complications and outcome in different categories of surgical patients. RECENT FINDINGS:The choice of perioperative haemodynamic monitoring for GDT depends on the surgery-related and the patient-related risk. Conventional monitoring and minimally invasive approaches can be used for perioperative optimization of low-risk to moderate-risk patients. Thermodilution methods and continuous cardiac output/oxygen transport monitoring are the most reliable techniques for major surgery and high-risk/unstable patients. An important goal of perioperative haemodynamic therapy is to maintain cardiac function and organ perfusion, optimizing the balance between oxygen delivery and consumption. Several studies, using different monitoring tools and end-points, have shown that GDT provides optimal haemodynamic performance, improves organ function, reduces the number of complications and time to ICU and hospital discharge and decreases the mortality rate in high-risk surgical patients. SUMMARY:GDT provides a number of benefits in major surgery. Based on adequate monitoring, the goal-directed algorithms facilitate early detection of pathophysiological changes and influence the perioperative haemodynamic therapy that can improve the clinical outcome. The perioperative GDT should be early, adequate and individualized for every patient.

journal_name

Curr Opin Crit Care

authors

Kirov MY,Kuzkov VV,Molnar Z

doi

10.1097/MCC.0b013e32833ab81e

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

384-92

issue

4

eissn

1070-5295

issn

1531-7072

journal_volume

16

pub_type

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