Perioperative Goal-Directed Therapy

Perioperative Goal-Directed Therapy Some Remaining Questions

Perioperative mortality of patients undergoing high-risk surgery has been steadily declining over recent years. And yet this reduced mortality rate is still considered to be higher than anticipated (Pearse et al. 2012). Newer approaches aimed at improving perioperative outcome and reducing its associated costs have been recently proposed. These include fast-track surgery (Kehlet and Wilmore 200...

Perioperative Goal-Directed Therapy Using Invasive Uncalibrated Pulse Contour Analysis

"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are a...

PRO: Perioperative Goal-Directed Fluid Therapy Is an Essential Element of an Enhanced Recovery Protocol.

Tackling the economic burden of postsurgical complications: would perioperative goal-directed fluid therapy help?

INTRODUCTION Pay-for-performance programs and economic constraints call for solutions to improve the quality of health care without increasing costs. Many studies have shown decreased morbidity in major surgery when perioperative goal directed fluid therapy (GDFT) is used. We assessed the clinical and economic burden of postsurgical complications in the University HealthSystem Consortium (UHC) ...

Perioperative goal directed therapy: evidence and compliance are two sides of the same coin.

Goal directed therapy (GDT) based on the optimization of cardiac output (CO) or dynamic parameters of fluid responsiveness have been shown to improve clinical outcome and to decrease the overall cost related to major surgery. This concept has recently been recommended by professional societies in the UK, in France, and in Europe. The most significant implementation has been made in the UK where...