Why the study?
Many hemodynamic monitoring techniques cannot directly identify the underlying cause of cardiovascular impairment during surgery in growing numbers of high-risk patients.
A proposed 6-step hemodynamic focused echocardiography approach provides a rapid diagnostic method to guide perioperative hemodynamic therapy in high-risk surgical patients.
May support individualized perioperative echo use in high-risk patients; leaves open prospective validation before practice change.
The number of high-risk patients undergoing surgery is growing. To maintain adequate hemodynamic functioning as well as oxygen delivery to the vital organs (DO 2 ) amongst this patient population, a rapid assessment of cardiac functioning is essential for the anesthesiologist. Pinpointing any underlying cardiovascular pathophysiology can be decisive to guide interventions in the intraoperative setting. Various techniques are available to monitor the hemodynamic status of the patient, however due to intrinsic limitations, many of these methods may not be able to directly identify the underlying cause of cardiovascular impairment. Hemodynamic focused echocardiography, as a rapid diagnostic method, offers an excellent opportunity to examine signs of filling impairment, cardiac preload, myocardial contractility and the function of the heart valves. We thus propose a 6-step-echocardiographic approach to assess high-risk patients in order to improve and maintain perioperative DO 2 . The summary of all echocardiographic based findings allows a differentiated assessment of the patient's cardiovascular function and can thus help guide a (patho)physiological-orientated and individualized hemodynamic therapy.
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Trauzeddel et al. (2020) studied this question.
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