Key result
Among 1,079 German anaesthesiologists, 94% focused on mean arterial pressure for monitoring, with 77% considering values below 60-65 mmHg critically low, and only 21% using internal protocols.
Why the study?
The study aimed to identify how anaesthetists in Germany managed intraoperative haemodynamics and blood pressure prior to the publication of the first German guideline on the topic.
Cross-Sectional (n=1,079)
This survey reveals that while German anaesthesiologists largely follow international recommendations for haemodynamic monitoring, the treatment of intraoperative hypotension is rarely protocol-driven and mostly relies on personal clinical experience.
Survey captures pre-guideline German practices; leaves open whether 2023 recommendations will standardize intraoperative haemodynamic management.
In 2023, the first German guideline on intraoperative haemodynamic monitoring and management for adults having non-cardiac surgery was published. The aim of this survey was to identify how anaesthetists in Germany managed intraoperative haemodynamics and blood pressure before its publication. In September to October 2023, members of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) were invited via email to participate in this anonymous online survey. Thirty-one questions covered demographics, clinical experience, approaches to perioperative blood pressure measurement and common thresholds, as well as the use of advanced haemodynamic monitoring and its potential therapeutic implications. 1,079 fully completed questionnaires were included in the analysis. When intermittent oscillometry was used to measure blood pressure, a 3-minute interval was usually applied during induction of anaesthesia (42%; 451/1,079). For invasive blood pressure monitoring, more than half (53%; 574/1,079) inserted an arterial line after induction of anaesthesia. Nearly all (94%; 1,012/1,079) focused on the mean arterial pressure for blood pressure monitoring, with a large majority (77%; 779/1012) considering values below 60-65 mmHg to be critically low. Intraoperative hypotension was managed based on an internal protocol by only 21% (223/1,079). Regarding advanced haemodynamic monitoring, 43% (459/1,079) frequently used pulse contour analysis, while 67% (721/1,079) reported that monitors with finger-cuff technology were not available in their department. 47% (504/1,079) cited a lack of experience as one of the main reasons for the infrequent use of cardiac output monitoring. This survey among DGAI members provides important insights into current practices of haemodynamic monitoring and management prior to the publication of the recent German guideline on 'Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery'.
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Vojnar et al. (2025) conducted a cross-sectional in Intraoperative haemodynamic monitoring and management (n=1,079). Survey on haemodynamic monitoring and management practices was evaluated on Practices of haemodynamic monitoring and management. Among 1,079 German anaesthesiologists, 94% focused on mean arterial pressure for monitoring, with 77% considering values below 60-65 mmHg critically low, and only 21% using internal protocols.
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