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Hemodynamic monitoring and management in high-risk surgery: a survey among Japanese anesthesiologists

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Abstract

The aim of this study was to assess the current practices of hemodynamic management in high-risk surgical patients among Japanese anesthesiologists. An invitation letter to the survey, which included 35 questions related to hemodynamic monitoring in high-risk surgery, was mailed to every hospital approved by the Japanese Society of Anesthesiologists (JSA) (1260 hospitals). Of the 692 JSA respondents, 573 completed the survey. Despite reporting a high rate of cardiac output (CO) and stroke volume variation (SVV) monitoring in JSA members (70 and 74 %, respectively), fluid goal-directed therapy was poorly implemented in high-risk surgery (7.4 %). Also, 47 % of the JSA respondents did not consistently perform CO optimization. SVV was more commonly used (76 %) as an indicator of volume expansion among JSA respondents, while central venous pressure was less frequently used (48 %). Despite a broader use of advanced hemodynamic monitoring, optimization of CO is still poorly protocolized and applied in Japan. The development of guidelines and protocols for hemodynamic management, including the establishment of strong evidence aimed at improving clinical outcomes, is needed to assist anesthesiologists in more universal adoption of perioperative CO optimization.

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Acknowledgments

The authors thank the JSA anesthesiologists participating in our survey. We also thank Sang-Hyun Kim MD, PhD (Department of Anesthesiology and Pain Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea) and Guo Chen, MD, Ph.D. (Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China) for supplying their data in the previous surveys [11, 12].

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Authors and Affiliations

  1. Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka City, Osaka, 545-8586, Japan

    Koichi Suehiro, Katsuaki Tanaka, Akira Mukai & Kiyonobu Nishikawa

  2. Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA

    Koichi Suehiro & Olivier Desebbe

  3. Department of Anesthesiology and Perioperative Care, Erasme University Hospital, Free University of Brussels, Brussels, Belgium

    Alexandre Joosten

  4. Department of Anesthesiology and Intensive Care, Clinique de la Sauvegarde, Lyon, France

    Olivier Desebbe

  5. Department of Anesthesiology, University of California San Diego, San Diego, CA, USA

    Brenton Alexander

  6. Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Maxime Cannesson

Authors
  1. Koichi Suehiro
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  2. Katsuaki Tanaka
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  3. Akira Mukai
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  4. Alexandre Joosten
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  5. Olivier Desebbe
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  6. Brenton Alexander
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  7. Maxime Cannesson
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  8. Kiyonobu Nishikawa
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Corresponding author

Correspondence to Koichi Suehiro.

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Conflict of interest

Maxime Cannesson is a consultant for Edwards Lifesciences (Irvine, CA), Covidien (Boulder, CO), Masimo Corp. (Irvine, CA), Gauss Surgical (Palo Alto, CA), and Philips Medical System (Suresnes, France). Maxime Cannesson has equity position in Sironis.

Funding

Only institutional and departmental funds were used in the present study.

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Suehiro, K., Tanaka, K., Mukai, A. et al. Hemodynamic monitoring and management in high-risk surgery: a survey among Japanese anesthesiologists. J Anesth 30, 526–529 (2016). https://doi.org/10.1007/s00540-016-2155-8

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  • DOI: https://doi.org/10.1007/s00540-016-2155-8

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