title: Development and feasibility study of an algorithm for intraoperative goaldirected haemodynamic management in noncardiac surgery.
abstract: 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 m2 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.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Charité-Universitätsmedizin Berlin Campus Virchow Klinikum and Campus Charité Mitte, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Feldheiser
authors.forename: P
authors.initials: P
authors.lastname: Conroy
authors.forename: T
authors.initials: T
authors.lastname: Bonomo
authors.forename: B
authors.initials: B
authors.lastname: Cox
authors.forename: T Ruiz
authors.initials: TR
authors.lastname: Garces
authors.forename: C
authors.initials: C
authors.lastname: Spies
mesh_terms: D000368:Aged; D002395:Catecholamines / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000628:therapy*; D007432:Intraoperative Period; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines