Current practice of hemodynamic monitoring and vasopressor and inotropic therapy in post‐operative cardiac surgery patients in Germany: results from a postal survey

Abstract

Hemodynamic monitoring and the variability in clinical practice with regard to volume replacement, transfusion triggers and the use of vasopressors/inotropes in cardiac surgery patients tend to follow the results of traditional experience rather than current scientific knowledge. Guidelines are therefore necessary to help to improve the standards of intensive care after cardiac surgery and thus the outcome of patients.

Comparison of values in critically ill patients for global end-diastolic volume and extravascular lung water measured by transcardiopulmonary thermodilution: A metaanalysis of the literature

“…Undoubtedly, the mean arterial pressure (MAP) is the most mentioned and most commonly used parameter in the treatment of circulatory insufficiency. 40 The Surviving Sepsis Campaign (SCC) Huber (2008) Schmidt (2007) Monnet (2007) Toth (2007) Kozieras (2007) Compton (2007) Kuzkov (2006) Kuhn (2006) Hoffmann (2005) Michelet (2005) Deja (2005) Patroniti (2005) Szakmany (2004) Faybik (2004) Deeren (2004) Sakka (2001) Sakka (2000) Raaijmakers (1998) Zeravik (1990) Figure 7 Forest plot of individual study results and pooled mean estimator from a random-effects meta analysis concerning EVLWI data in non-surgical patients (SEP).…”

Fluid Management and Electrolyte Balance

“…In cardio-surgical ICU, CVP is the most used (87 % of intensivists), followed by MAP (84 %) and PCWP (30 %) (Kastrup et al 2007). Many studies have shown that CVP does not adequately reflect preload and fails to predict fluid responsiveness (Agrò and Vennari 2013b;Kastrup et al 2007;Cavallaro et al 2008;Marik et al 2008).…”

Are renal adverse effects of hydroxyethyl starches merely a consequence of their incorrect use?

“…According to these results, HES is now the preferred colloid in many European countries in the intensive care as well as in the operative setting. Data about the use of HES in Germany were based on postal surveys during 1998 [29] and 2004/5 [34]. In 1998, HES use was reported in 67% of 286 intensive care units [29].…”

“…In the past years, description of volume therapy in acute hypovolemia was derived mainly from self-administered questionnaires [29][30][31][32][33][34][35][36]. According to these results, HES is now the preferred colloid in many European countries in the intensive care as well as in the operative setting.…”