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Goal-directed haemodynamic therapy: an imprecise umbrella term to avoid.

Bernd Saugel¹, Kristen K Thomsen², Kamal Maheshwari³

¹Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Outcomes Research Consortium, Cleveland, OH, USA.

British Journal of Anaesthesia

|February 2, 2023

Summary

The term 'goal-directed haemodynamic therapy' is an imprecise umbrella term. Different strategies under this umbrella have varying targets and outcomes, necessitating a more specific approach.

Keywords:

arterial pressure blood pressure cardiac index cardiac output goal-directed therapy haemodynamic monitoring pulse pressure variation stroke volume

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Area of Science:

Critical care medicine
Cardiovascular physiology
Clinical interventions

Background:

Goal-directed haemodynamic therapy (GDHT) encompasses diverse strategies aimed at achieving specific physiological targets.
These strategies vary significantly in their chosen haemodynamic variables and target values.

Discussion:

Lumping diverse haemodynamic interventions under the single term GDHT oversimplifies complex clinical practices.
The heterogeneity within GDHT likely influences patient outcomes differently, warranting nuanced consideration.

Key Insights:

GDHT strategies differ substantially in target variables and values.
The current umbrella term for these therapies is imprecise and potentially misleading.
A more specific terminology is needed to reflect the distinct nature of these interventions.

Outlook:

Future research should differentiate between specific GDHT protocols to clarify outcome associations.
Developing precise terminology will enhance clinical communication and research accuracy.
This refinement is crucial for advancing evidence-based haemodynamic management.