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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

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Published on: January 27, 2023

Perioperative hemodynamic optimization - Paediatrics.

Jean-Luc Fellahi, Matthieu Biais, Osama Abou-Arab

Anaesthesia, Critical Care & Pain Medicine

|November 3, 2025

Summary

This summary is machine-generated.

The French Society for Anaesthesia and Intensive Care developed nine guidelines for pediatric perioperative hemodynamic optimization. These guidelines, based on rigorous evidence assessment, aim to improve patient care during surgery and intensive care.

Keywords:

Guidelines Haemodynamics Perioperative

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Area of Science:

Anesthesiology and Intensive Care Medicine
Pediatric Critical Care
Evidence-Based Medicine

Background:

The French Society for Anaesthesia and Intensive Care (SFAR) previously issued guidelines on perioperative vascular filling in 2012.
Updating these guidelines was necessary to incorporate current evidence and best practices in hemodynamic management.
Perioperative hemodynamic optimization is crucial for improving patient outcomes in surgical and intensive care settings.

Purpose of the Study:

To develop updated guidelines for perioperative hemodynamic optimization specifically for pediatric patients.
To systematically review and synthesize the available evidence on hemodynamic management in pediatric perioperative care.
To provide expert consensus recommendations for clinical practice.

Main Methods:

A committee of 27 experts, including pediatric specialists, was convened.
The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was employed to assess evidence quality.
Guideline questions were formulated using the PICO format, and a Professional Practice Guidelines format was adopted due to limited high-power studies.

Main Results:

Nine guidelines for pediatric perioperative hemodynamic optimization were formulated with strong expert agreement.
The guidelines cover key areas including arterial pressure, volume expansion, vasopressors, and inotropes.
Recommendations could not be formulated for four specific questions due to insufficient evidence.

Conclusions:

Nine comprehensive guidelines on pediatric perioperative hemodynamic optimization have been established.
These guidelines reflect a high degree of consensus among the expert panel.
The recommendations provide a framework for evidence-based hemodynamic management in pediatric perioperative care.