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Perioperative Goal-directed Therapy: Monitoring, Protocolized Care and Timing

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Annual Update in Intensive Care and Emergency Medicine 2012

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM,volume 2012))

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Abstract

In the 1970s, Shoemaker observed that patients who survived high-risk surgical interventions had distinct hemodynamic patterns [1]. These included higher mean global oxygen delivery (DO2), cardiac index (CI) and tissue oxygen demand (VO2) than non-survivors. Shoemaker went on to develop the concept of perioperative optimization by using the survivors’ patterns as therapeutic goals [2]. Amongst survivors, consistent ‘supranormal’ oxygen flow physiological values were noted of DO2 > 600 ml/min/m2, VO2 > 170 ml/min/m2 and CI > 4.5 l/min/m2 [3]. Positive results in initial uncontrolled studies were corroborated by a controlled trial that used supranormal goals for hemodynamic optimization in the protocol group of high-risk surgical patients [4]. This protocol decreased mortality and spurred a wave of interest in perioperative goal directed therapy (GDT).

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Authors
  1. M. Cecconi
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  2. C. Corredor
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  3. A. Rhodes
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Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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Cecconi, M., Corredor, C., Rhodes, A. (2012). Perioperative Goal-directed Therapy: Monitoring, Protocolized Care and Timing. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2012. Annual Update in Intensive Care and Emergency Medicine, vol 2012. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25716-2_34

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  • DOI: https://doi.org/10.1007/978-3-642-25716-2_34

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  • Online ISBN: 978-3-642-25716-2

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