Open AccessDevelopment and Feasibility Study of an Algorithm for Intraoperative Goal-Directed Haemodynamic Management in Noncardiac Surgery
Author(s) -
Aarne Feldheiser,
Patrick Conroy,
T Bonomo,
B Cox,
Tomàs Garcés,
Claudia Spies
Publication year - 2012
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/147323001204000402
Subject(s) - medicine , hemodynamics , inotrope , stroke volume , anesthesia , cardiac index , mean arterial pressure , algorithm , blood pressure , cardiac output , heart rate , cardiology , computer science
This study developed an evidence-based, goal-directed haemodynamic management algorithm to standardize intraoperative haemodynamic therapy. A systematic literature search identified three haemodynamic management goals: stroke volume optimization by fluid therapy; maintenance of a target mean arterial pressure by vasopressor therapy; maintenance of a target cardiac index ≥ 2.5 l/min per m 2 by inotropic therapy. The algorithm was adapted to international standards and consensus was reached through a modified Delphi method at international meetings. Implementation of the algorithm into routine intraoperative management in noncardiac surgery was shown to be feasible. Compared with conventional haemodynamic management, use of the algorithm significantly reduced length of hospital stay, requirement for ventilation and incidence of prolonged hospital stay, thereby resulting in reduced hospital costs.