title: Perioperative goal-directed haemodynamic therapy based on flow parameters: a concept in evolution.
abstract: Haemodynamic management incorporating direct or surrogate stroke volume monitoring has experienced a rapid evolution, because of emergence of the "goal-directed therapy" concept and technological developments aimed at providing a parameter leading to the goal. Nonetheless, consensus on both definitions of the ideal "goal" and strategies for achieving it remain elusive. For this review, we first consider basic physiological and patient monitoring factors relevant to the concept of "fluid responsiveness", and then focus upon randomized controlled trials and meta-analyses involving goal-directed haemodynamic therapy based on various flow parameters. Finally, we discuss the current status of noninvasive methods for monitoring fluid responsiveness.
authors.affiliation: Department of Anesthesiology, Yale University School of Medicine, 330 Cedar St., PO Box 208051, New Haven, CT 06520, USA.
authors.forename: L
authors.initials: L
authors.lastname: Meng
authors.affiliation: Department of Anesthesiology, Yale University School of Medicine, 330 Cedar St., PO Box 208051, New Haven, CT 06520, USA paul.heerdt@yale.edu.
authors.forename: P M
authors.initials: PM
authors.lastname: Heerdt
mesh_terms: D005440:Fluid Therapy; D006040:Goals; D006439:Hemodynamics; D006801:Humans; D019990:Perioperative Care / Q000379:methods*
keywords: blood pressure; fluid therapy; haemodynamics; monitoring; stroke volume