Development and Feasibility Study of an Algorithm for Intraoperative Goal-directed Haemodynamic Management in Noncardiac Surgery

A. Feldheiser, P. Conroy, T. Bonomo, B. Cox, T. Ruiz Garces, C. Spies*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

45 Citations (Web of Science)

Abstract

This study developed an evidence-based, goal-directed haemodynamic management algorithm to standardize intraoperative haemodynamic therapy. A systematic literature search identified three haemodynamic management goals: stroke volume optimization by fluid therapy; maintenance of a target mean arterial pressure by vasopressor therapy; maintenance of a target cardiac index >= 2.5 l/min per m(2) by inotropic therapy. The algorithm was adapted to international standards and consensus was reached through a modified Delphi method at international meetings. Implementation of the algorithm into routine intraoperative management in noncardiac surgery was shown to be feasible. Compared with conventional haemodynamic management, use of the algorithm significantly reduced length of hospital stay, requirement for ventilation and incidence of prolonged hospital stay, thereby resulting in reduced hospital costs.
Original languageEnglish
Pages (from-to)1227-1241
JournalJournal of International Medical Research
Volume40
Issue number4
DOIs
Publication statusPublished - 2012

Keywords

  • HAEMODYNAMIC MONITORING
  • FLUID THERAPY
  • VASOPRESSOR THERAPY
  • INOTROPISM
  • GOAL-DIRECTED THERAPY

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