Post-operative consequences of hemodynamic optimization.
Hemodynamic optimization begins with a medical assessment to identify the high-risk patients. This stratification is needed to customize the choice of hemodynamic support that is best adapted to the patient's level of risk, integrating the use of the least invasive procedures. The macro-circulatory hemodynamic approach aims to maintain a balance between oxygen supply (DO2) and oxygen demand (VO2). Volume replacement plays a crucial role based on the titration of fluid boluses according to their effect on measured stroke volume or indices of preload dependency. Good function of the microcirculatory system is the best guarantee to achieve this goal. An assessment of the DO2/VO2ratio is needed for guidance in critical situations where tissue hypoxia may occur. Overall, all of these strategies are based on objective criteria to guide vascular replacement and/or tissue oxygenation in order to improve the patient's post-operative course by decreasing morbidity and hospital stay.
Univ.Lille, CHU Lille, Pôle d'Anesthésie Réanimation, 59000 Lille, France.
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Lazkani
Univ.Lille, CHU Lille, EA7365 - GRITA - Groupe de Recherche sur les Formes Injectables et technologies Associées, Pôle d'Anesthésie Réanimation, 59000 Lille, France. Electronic address: gilles.lebuffe@chru-lille.fr.
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Lebuffe
D001784:Blood Gas Analysis; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology*; D006706:Homeostasis; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D010100:Oxygen / Q000008:administration & dosage*; D010101:Oxygen Consumption / Q000502:physiology; D061214:Patient Safety; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D013318:Stroke Volume / Q000502:physiology
D010100:Oxygen
Goal directed fluid therapy; Morbidity; Peri-operative hemodynamic optimization