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Haemodynamic coherence in perioperative setting.

Andrea Carsetti1, Ximena Watson2, Maurizio Cecconi3

  • 1Anaesthesia and Intensive Care Unit, ASUR Marche - Area Vasta n. 4, Italy.

Best Practice & Research. Clinical Anaesthesiology
|December 10, 2016
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Summary
This summary is machine-generated.

Goal-directed therapy (GDT) can optimize hemodynamics in high-risk surgery. However, this review highlights that GDT may not always resolve microvascular dysfunction, emphasizing the need for comprehensive assessment.

Keywords:
goal-directed therapyhaemodynamic monitoringhaemodynamic optimisationperioperative

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Sciences

Background:

  • Increased interest in goal-directed therapy (GDT) for high-risk surgery over the past decade.
  • Development of various hemodynamic monitoring tools for perioperative care.
  • Patient and surgical complexity influence the benefit of GDT.

Purpose of the Study:

  • To review hemodynamic optimization strategies in the perioperative period.
  • To discuss the assessment of microvascular function during surgery.
  • To provide an overview of GDT's role in managing tissue perfusion.

Main Methods:

  • Literature review focusing on perioperative hemodynamic management.
  • Analysis of the relationship between macrovascular and microvascular circulation.
  • Discussion of current monitoring tools and their limitations.

Main Results:

  • Hemodynamic optimization using GDT is crucial for perioperative care.
  • Global hemodynamic parameters can be improved with GDT.
  • Microvascular impairment may persist despite optimized macrovascular hemodynamics.

Conclusions:

  • Ensuring optimal tissue perfusion requires addressing both macrovascular and microvascular aspects.
  • GDT is a valuable tool, but its application needs careful consideration of patient and surgical factors.
  • Further research into microvascular assessment is needed to complement GDT.