2007
DOI: 10.1111/j.1399-6576.2006.01221.x
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Monitoring of peri‐operative fluid administration by individualized goal‐directed therapy

M. Bundgaard‐Nielsen,
K. Holte,
N. H. Secher
et al.

Abstract: Goal-directed therapy with the maximization of flow-related haemodynamic variables reduces hospital stay, PONV and complications, and facilitates faster gastrointestinal functional recovery. So far, oesophageal Doppler is recommended, but other monitors are available and call for evaluation.

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Cited by 253 publications
(180 citation statements)
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References 72 publications
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“…34 Therefore, HR and MAP can function only as rough indicators of patient status that can trigger intervention, such as a fluid challenge, 35 and cannot be used reliably to measure changes in central blood volume or as an indicator of hypovolemia. 36 Nevertheless, in cases of sudden unexpected blood loss with hypotension, a fluid challenge should be given with the goal of restoring blood pressure and, therefore, perfusion and oxygen delivery.…”
Section: Maintenance Fluid Therapymentioning
confidence: 99%
“…34 Therefore, HR and MAP can function only as rough indicators of patient status that can trigger intervention, such as a fluid challenge, 35 and cannot be used reliably to measure changes in central blood volume or as an indicator of hypovolemia. 36 Nevertheless, in cases of sudden unexpected blood loss with hypotension, a fluid challenge should be given with the goal of restoring blood pressure and, therefore, perfusion and oxygen delivery.…”
Section: Maintenance Fluid Therapymentioning
confidence: 99%
“…The majority of the available studies in literature published before 2006 compared GDT with a liberal approach to fluid administration in patients who were mainly ASA 1 or 2, and generated results in favour of GDT (25). Later studies that compared GDT with a restricted approach or ERAS programme showed no differences, and again mainly concerned ASA 1 or ASA 2 patients (26,27).…”
Section: Gdt Decreases Risk Of Complications During the First 30 Postmentioning
confidence: 99%
“…To direct fluid administration on the basis of establishing maximal values for stroke volume or CO requires that there is added a rule to limit the fluid administered. A common algorithm implies that a 10%, or larger increase in stroke volume justifies further administration of 200-250 ml of colloid, thereby minimizing the risk of creating a fluid overload (Bundgaard-Nielsen et al, 2007a). In contrast, during isovolaemic haemodilution, S v O 2 remains stable until the haemoglobin level is reduced by approximately 50% (Krantz et al, 2005) and volume administration based on the recording of S c O 2 is therefore widely independent of the type of fluid used.…”
Section: Normovolaemiamentioning
confidence: 99%
“…Despite these limitations in the use of HR and MAP to detect deviations in CBV, the capability to balance CBV is of importance for tissue perfusion and oxygenation and notably for oxygenation of the brain (S c O 2 ) (Nissen et al, 2009a), indicating that advanced cardiovascular monitoring is required to secure the well-being of the patient (Yao et al, 2004;Bundgaard-Nielsen et al, 2007a;Murkin et al, 2007) In order to maintain CBV during surgery, it is important that normovolaemia is defined. For supine humans the heart operates on the upper flat part of the Frank-Starling curve (Harms et al, 2003) and to establish and to maintain a maximal resting stroke volume for the heart (or CO) secures that the patient remains normovolaemic during the operation and that fluid administration strategy reduces postoperative complications to an extent that affects the hospital stay (Bundgaard-Nielsen et al, 2007a). Such goal directed fluid therapy was introduced by Shoemaker et al (Shoemaker, 1972;Shoemaker et al, 1988) in regard to CO but without taking the individual and partly genetically determined differences in CO (Snyder et al, 2006) into account.…”
mentioning
confidence: 99%