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13 results

  • 12 - Perioperative Goal-Directed Hemodynamic Therapy

  • from Section 3 - Practical Use
    • By
  • Edited by Alexandre Joosten, University of California, Los Angeles, Maxime Cannesson, University of California, Los Angeles, Robert G. Hahn, Karolinska Institutet, Stockholm
  • Book:
    Hemodynamic Monitoring and Fluid Therapy during Surgery
    Published online:
    11 April 2024
    Print publication:
    02 May 2024, pp 125-135

  • Summary

    Perioperative goal-directed hemodynamic therapy aims at optimizing global hemodynamics during the perioperative period by titrating fluids, vasopressors, and/or inotropes to reach predefined hemodynamic goals. Current evidence indicates that treating patients according to perioperative goal-directed hemodynamic therapy protocols reduces morbidity and mortality, particularly in patients having high-risk surgery. However, its adoption into clinical practice is still weak.

    This strategy has also improved greatly over the past 40 years. Monitoring technology has evolved to enable very invasive devices to be replaced by much less invasive (and even totally non-invasive) equipment. Simultaneously, our whole approach to monitoring has shifted from using a few static, single measures to a functional, dynamic, and multivariable approach. Finally, we are moving from standard, protocolized hemodynamic strategies to a more personalized approach to ensure appropriate management of each patient. For this purpose, closed-loop systems are an appealing added value to ensure that therapies are delivered appropriately to all patients.

Hemodynamic Monitoring and Fluid Therapy during Surgery
  • Edited by Alexandre Joosten, Maxime Cannesson, Robert G. Hahn
  • Published online:
    11 April 2024
    Print publication:
    02 May 2024
  • Combining two successful texts, Clinical Fluid Therapy in the Perioperative Setting, 2nd edition and Perioperative Hemodynamic Monitoring and Goal Directed Therapy, this revised volume provides a guide to fluid management and hemodynamic therapy for the perioperative practitioner. The book begins with an up-to-date overview of the basics before then exploring most of the current and controversial topics within hemodynamic monitoring and fluid therapy. This is followed by a section on practical use which explores hemodynamic and fluid therapy in various types of surgery and patient conditions. The book closes with a discussion of the future concepts in fluid and hemodynamic therapy ranging from microcirculation, to closed-loop and mobiles technologies. With contributions from the world's leading experts, chapters guide the reader in the application of fluid and hemodynamic therapy in all aspects of perioperative patient care. A valuable resource for those involved in perioperative patient management, including anaesthesiologists, intensivists, and surgeons.