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Related Concept Videos

Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...

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Related Experiment Video

Updated: May 10, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
14:09

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

Does goal-directed fluid therapy affect postoperative orthostatic intolerance?: A randomized trial.

Morten Bundgaard-Nielsen1, Øivind Jans, Rasmus G Müller

  • 1* Research Fellow, ‡ Research Assistant, Section of Surgical Pathophysiology, The Juliane Marie Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark, and Department of Anesthesiology, The Abdominal Center, Copenhagen University Hospital, Rigshospitalet. † Research Fellow, †† Professor, Section of Surgical Pathophysiology, The Juliane Marie Center, Copenhagen University Hospital, Rigshospitalet. § Staff Anesthesiologist, ‖ Head of Department, ** Professor, Department of Anesthesiology, The Abdominal Center, Copenhagen University Hospital, Rigshospitalet. # Professor, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.

Anesthesiology
|June 13, 2013
PubMed
Summary

Goal-directed therapy (GDT) did not reduce orthostatic intolerance (OI) after major surgery. Patients with OI experienced longer hospital stays and impaired responses to mobilization.

Related Experiment Videos

Last Updated: May 10, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
14:09

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Recovery

Background:

  • Early postoperative mobilization is crucial for recovery but frequently hindered by orthostatic intolerance (OI).
  • Postoperative OI, affecting 50% of patients 6 hours after major surgery, is linked to hypovolemia and vasomotor dysregulation.
  • Stroke volume-guided fluid therapy, or goal-directed therapy (GDT), aims to correct functional hypovolemia.

Purpose of the Study:

  • To investigate whether GDT can decrease the incidence of OI following major surgery.
  • To assess the efficacy of GDT in managing postoperative orthostatic intolerance.

Main Methods:

  • A prospective, double-blinded trial involving 42 patients undergoing radical prostatectomy.
  • Patients were randomized to standard fluid therapy (control) or GDT, with GDT receiving additional colloid guided by stroke volume (esophageal Doppler).
  • Orthostatic intolerance was assessed using a standardized mobilization protocol before and 6 hours post-surgery, with hemodynamic and hormonal responses evaluated.

Main Results:

  • The prevalence of OI was 57% in the control group and 71% in the GDT group (P = 0.33), indicating no significant reduction with GDT.
  • The GDT group received more colloid (1,758 vs. 1,057 ml; P = 0.001) and achieved higher stroke volumes (102 vs. 89 ml; P = 0.04).
  • Patients with OI experienced longer hospital stays (3 vs. 2 days; P = 0.02) and showed impaired hemodynamic and norepinephrine responses during mobilization.

Conclusions:

  • Goal-directed therapy did not significantly reduce the prevalence of orthostatic intolerance after major surgery.
  • Orthostatic intolerance in the postoperative period is associated with impaired cardiovascular and hormonal responses to mobilization.
  • Further research may be needed to explore alternative strategies for preventing or managing postoperative OI.