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Clinical review: What are the best hemodynamic targets for noncardiac surgical patients?
Crit Care. 2013 Mar 19; 17(2):210.CC

Abstract

Perioperative hemodynamic optimization, or goal-directed therapy (GDT), has been show to significantly decrease complications and risk of death in high-risk patients undergoing noncardiac surgery. An important aim of GDT is to prevent an imbalance between oxygen delivery and oxygen consumption in order to avoid the development of multiple organ dysfunction. The utilization of cardiac output monitoring in the perioperative period has been shown to improve outcomes if integrated into a GDT strategy. GDT guided by dynamic predictors of fluid responsiveness or functional hemodynamics with minimally invasive cardiac output monitoring is suitable for the majority of patients undergoing major surgery with expected significant volume shifts due to bleeding or other significant intravascular volume losses. For patients at higher risk of complications and death, such as those with advanced age and limited cardiorespiratory reserve, the addition of dobutamine or dopexamine to the treatment algorithm, to maximize oxygen delivery, is associated with better outcomes.

Authors

No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23672840

Citation

Lobo, Suzana Margareth, and Neymar Elias de Oliveira. "Clinical Review: what Are the Best Hemodynamic Targets for Noncardiac Surgical Patients?" Critical Care (London, England), vol. 17, no. 2, 2013, p. 210.
Lobo SM, de Oliveira NE. Clinical review: What are the best hemodynamic targets for noncardiac surgical patients? Crit Care. 2013;17(2):210.
Lobo, S. M., & de Oliveira, N. E. (2013). Clinical review: What are the best hemodynamic targets for noncardiac surgical patients? Critical Care (London, England), 17(2), 210. https://doi.org/10.1186/cc11861
Lobo SM, de Oliveira NE. Clinical Review: what Are the Best Hemodynamic Targets for Noncardiac Surgical Patients. Crit Care. 2013 Mar 19;17(2):210. PubMed PMID: 23672840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical review: What are the best hemodynamic targets for noncardiac surgical patients? AU - Lobo,Suzana Margareth, AU - de Oliveira,Neymar Elias, Y1 - 2013/03/19/ PY - 2013/5/16/entrez PY - 2013/5/16/pubmed PY - 2015/4/22/medline SP - 210 EP - 210 JF - Critical care (London, England) JO - Crit Care VL - 17 IS - 2 N2 - Perioperative hemodynamic optimization, or goal-directed therapy (GDT), has been show to significantly decrease complications and risk of death in high-risk patients undergoing noncardiac surgery. An important aim of GDT is to prevent an imbalance between oxygen delivery and oxygen consumption in order to avoid the development of multiple organ dysfunction. The utilization of cardiac output monitoring in the perioperative period has been shown to improve outcomes if integrated into a GDT strategy. GDT guided by dynamic predictors of fluid responsiveness or functional hemodynamics with minimally invasive cardiac output monitoring is suitable for the majority of patients undergoing major surgery with expected significant volume shifts due to bleeding or other significant intravascular volume losses. For patients at higher risk of complications and death, such as those with advanced age and limited cardiorespiratory reserve, the addition of dobutamine or dopexamine to the treatment algorithm, to maximize oxygen delivery, is associated with better outcomes. SN - 1466-609X UR - https://www.unboundmedicine.com/medline/citation/23672840/Clinical_review:_What_are_the_best_hemodynamic_targets_for_noncardiac_surgical_patients L2 - https://ccforum.biomedcentral.com/articles/10.1186/cc11861 DB - PRIME DP - Unbound Medicine ER -