Perioperative Quality Initiative consensus statement on goal-directed haemodynamic therapy
Mark R Edwards1, Gudrun Kunst2, Lui G Forni3
1Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton, UK.
British Journal of Anaesthesia
|July 10, 2025
Summary
Updated consensus statements suggest considering goal-directed haemodynamic therapy (GDHT) for specific surgical patients, but caution against routine use in others. Future research should focus on personalized GDHT and AI-driven predictive models.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Surgical Outcomes
Background:
- Perioperative goal-directed haemodynamic therapy (GDHT) involves protocols for managing circulatory function during surgery.
- The 11th Perioperative Quality Initiative (POQI) convened to update consensus statements on perioperative GDHT.
Purpose of the Study:
- To propose updated consensus statements on the definitions, components, and physiology of perioperative GDHT.
- To provide evidence-based recommendations for the use of GDHT in various surgical settings.
Main Methods:
- Consensus development meeting of the Perioperative Quality Initiative (POQI).
- Review and synthesis of existing evidence and expert opinion on GDHT.
Main Results:
- Consideration of GDHT is recommended in specific settings like cardiopulmonary bypass, post-cardiac surgery, and hip fracture surgery, though evidence is weak.
- GDHT protocols may be used for moderate- to high-risk patients undergoing major noncardiac surgery, but fixed low-dose inotropes are not recommended.
- Routine GDHT is not recommended for elective abdominal surgery, and evidence is insufficient for emergency abdominal surgery.
Conclusions:
- GDHT application requires careful consideration based on surgical context and patient risk.
- Future research should prioritize individualized GDHT, technology-assisted protocols, and AI in predictive modeling for hemodynamic management.
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