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Published on: May 28, 2019

[Target-oriented infusion therapy in patients during myocardial revascularization]

I A Tolstova, B A Aksel'rod, M M Shmyrin

    Anesteziologiia I Reanimatologiia
    |November 27, 2009
    PubMed

    Insights

    Goal-oriented infusion therapy, targeting optimal preload, minimizes hemodynamic issues during heart surgery. This approach reduces the need for heart medications and shortens breathing support duration in patients undergoing myocardial revascularization.

    Area of Science:

    • Cardiology
    • Anesthesiology
    • Critical Care Medicine

    Context:

    • Myocardial revascularization on a working heart requires precise fluid management.
    • Standard infusion therapy relies on general hemodynamic parameters.
    • Individualized fluid management strategies may improve patient outcomes.

    Purpose:

    • To evaluate the efficacy of goal-oriented infusion therapy in maintaining optimal preload during myocardial revascularization.
    • To compare hemodynamic stability and resource utilization between goal-oriented and standard infusion therapy.

    Summary:

    • Forty-seven patients with coronary heart disease were divided into two groups: standard infusion therapy (control) and goal-oriented infusion therapy.
    • The goal-oriented group focused on maintaining the individual optimal preload (global end-diastolic volume index) using passive leg raising tests.
    • This individualized approach aimed to optimize fluid administration based on preload responsiveness.

    Impact:

    • Goal-oriented infusion therapy significantly minimized hemodynamic disorders during surgery.
    • It led to a reduced need for cardiotonic agents.
    • The duration of artificial ventilation was also decreased in the goal-oriented group.

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