Perioperative goal-directed haemodynamic therapy based on flow parameters: a concept in evolution.
L Meng1, P M Heerdt2
1Department of Anesthesiology, Yale University School of Medicine, 330 Cedar St., PO Box 208051, New Haven, CT 06520, USA.
British Journal of Anaesthesia
|December 13, 2016
Summary
Goal-directed hemodynamic therapy using stroke volume monitoring has evolved rapidly. However, defining the ideal "goal" and strategies for fluid responsiveness remains challenging, despite technological advances.
Area of Science:
- Critical care medicine
- Cardiovascular physiology
- Medical technology
Background:
- Hemodynamic management has advanced with the
- goal-directed therapy
- concept and technology for stroke volume monitoring.
Purpose of the Study:
- To review physiological factors and patient monitoring relevant to fluid responsiveness.
- To analyze randomized controlled trials and meta-analyses on goal-directed hemodynamic therapy using flow parameters.
- To discuss current noninvasive methods for monitoring fluid responsiveness.
Main Methods:
- Literature review of physiological principles and patient monitoring.
- Analysis of randomized controlled trials and meta-analyses on hemodynamic therapy.
- Discussion of noninvasive monitoring techniques for fluid responsiveness.
Main Results:
- The evolution of hemodynamic management is driven by goal-directed therapy and technological advancements.
- Consensus on optimal hemodynamic goals and fluid administration strategies is lacking.
- Various flow parameters are used in goal-directed hemodynamic therapy, with ongoing research into noninvasive monitoring.
Conclusions:
- Despite advancements, defining precise goals and strategies for hemodynamic management remains an area of active research.
- Further investigation is needed to establish optimal noninvasive methods for assessing fluid responsiveness.
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