Related Experiment Video

Updated: Sep 16, 2025

Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care
14:28

Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care

Published on: May 10, 2024

1.7K

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
PubMed

Insights

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.

Keywords:
cardiac outputfluid therapygoal-directed haemodynamic therapyinotropesperioperative blood pressure

More Related Videos

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.2K
Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs07:51

Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

Published on: May 21, 2019

7.5K

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
29
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.
36
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
29
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure01:16

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure

Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
323
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
81
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
633