| Title: |
Intra-operative haemodynamic monitoring and management of adults having noncardiac surgery: A statement from the European Society of Anaesthesiology and Intensive Care |
| Authors: |
Saugel, B.; Buhre, W.; Chew, M. S.; Cholley, B.; Coburn, M.; Cohen, B.; de Hert, S.; Duranteau, J.; Fellahi, J. L.; Flick, M.; Guarracino, F.; Joosten, A.; Jungwirth, B.; Kouz, K.; Longrois, D.; Buse, G. L.; Meidert, A. S.; Rex, S.; Romagnoli, S.; Romero, C. S.; Sander, M.; Thomsen, K. K.; Vos, J. J.; Zarbock, A. |
| Contributors: |
Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf Hamburg (UKE); University Medical Center Utrecht (UMCU); Karolinska University Hospital Stockholm; Hôpital Européen Georges Pompidou APHP (HEGP); Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO); University Hospital Bonn; Tel Aviv University (TAU); Universiteit Gent = Ghent University = Université de Gand (UGent); Hôpital Bicêtre AP-HP, Le Kremlin-Bicêtre; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Hôpital Louis Pradel CHU - HCL; Hospices Civils de Lyon (HCL); Azienda Ospedaliera Universitaria Pisana; University of California Los Angeles (UCLA); University of California (UC); Universitätsklinikum Ulm - University Hospital of Ulm; AP-HP - Hôpital Bichat - Claude Bernard Paris; Université Paris Cité (UPCité); Heinrich Heine Universität Düsseldorf = Heinrich Heine University Düsseldorf; University Hospital LMU Munich; Ludwig Maximilian University Munich = Ludwig Maximilians Universität München (LMU); Universitair Ziekenhuis Leuven = University Hospital of Leuven = Hopital universitaire de Louvain (UZ Leuven); Università degli Studi di Firenze = University of Florence = Université de Florence (UniFI); Azienda Ospedaliero Universitaria Careggi Firenze = Careggi University Hospital Florence, Italy (AOUC); Consortium General University Hospital of Valencia Spain (CGUHV); University Hospital Giessen and Marburg = Universitätsklinikum Gießen und Marburg (UKGM); Justus-Liebig-Universität Gießen = Justus Liebig University (JLU); University Medical Center Groningen Groningen (UMCG); University of Groningen Groningen; University Hospital Münster - Universitaetsklinikum Muenster Germany (UKM) |
| Source: |
ISSN: 0265-0215. |
| Publisher Information: |
CCSD; Lippincott, Williams & Wilkins |
| Publication Year: |
2025 |
| Subject Terms: |
Medical/standards; Societies; Review Literature as Topic; Hemodynamics/physiology; Operative/methods/standards/adverse effects; Surgical Procedures; Intraoperative/methods/standards; Monitoring; Hemodynamic Monitoring/methods/standards; Critical Care/methods/standards; Anesthesiology/standards/methods; Cardiac Output/physiology; Europe; Adult; Humans; [SDV]Life Sciences [q-bio] |
| Description: |
International audience ; This article was developed by a diverse group of 25 international experts from the European Society of Anaesthesiology and Intensive Care (ESAIC), who formulated recommendations on intra-operative haemodynamic monitoring and management of adults having noncardiac surgery based on a review of the current evidence. We recommend basing intra-operative arterial pressure management on mean arterial pressure and keeping intra-operative mean arterial pressure above 60 mmHg. We further recommend identifying the underlying causes of intra-operative hypotension and addressing them appropriately. We suggest pragmatically treating bradycardia or tachycardia when it leads to profound hypotension or likely results in reduced cardiac output, oxygen delivery or organ perfusion. We suggest monitoring stroke volume or cardiac output in patients with high baseline risk for complications or in patients having high-risk surgery to assess the haemodynamic status and the haemodynamic response to therapeutic interventions. However, we recommend not routinely maximising stroke volume or cardiac output in patients having noncardiac surgery. Instead, we suggest defining stroke volume and cardiac output targets individually for each patient considering the clinical situation and clinical and metabolic signs of tissue perfusion and oxygenation. We recommend not giving fluids simply because a patient is fluid responsive but only if there are clinical or metabolic signs of hypovolaemia or tissue hypoperfusion. We suggest monitoring and optimising the depth of anaesthesia to titrate doses of anaesthetic drugs and reduce their side effects. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40308048; PUBMED: 40308048 |
| DOI: |
10.1097/eja.0000000000002174 |
| Availability: |
https://inserm.hal.science/inserm-05193293; https://doi.org/10.1097/eja.0000000000002174 |
| Accession Number: |
edsbas.C4ED14B2 |
| Database: |
BASE |