Key result
Rigorous haemodynamic monitoring for perioperative fluid balance reduces mortality, length of stay, and costs, with new minimally invasive techniques increasingly replacing pulmonary artery catheters.
Rigorous haemodynamic monitoring is essential for guiding perioperative fluid therapy and improving patient outcomes, with newer minimally invasive techniques increasingly replacing the pulmonary artery catheter.
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May inform perioperative protocols but should not change practice; leaves open need for RCTs on minimally invasive monitoring.
Careful assessment of the fluid balance is required in the perioperative period since appropriate fluid therapy is essential for successful patient's outcome. Haemodynamic monitoring allows understanding the physiology of the circulation and changes of fluid balance in the perioperative period. This is diagnostic aid and guide for fluid replacement therapy. Patient's volume status is frequently assessed by different haemodynamic variables that could be targeted as the endpoints for fluid therapy and resuscitation. Fluid balance is the crucial factor in the maintenance of haemodynamic stability, tissue oxygenation and organ function. When the haemodynamic monitoring is applied in a rigorous and consistent manner, it reduces mortality and length of stay as well as costs incurred. There are a number of tests which describe the effectiveness of the invasive haemodynamic monitoring procedures usage. Since the pulmonary artery catheter (PAC) had been introduced into clinical practice it was considered as a golden standard for cardiac output measurements, haemodynamic and fluid balance assessment. Nevertheless, in previous 10 years new minimally invasive and noninvasive simple techniques for haemodynamic monitoring and patient's hydroelectricity status evaluation have been developed. They can replace PAC under different clinical circumstances and some of these techniques
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Sindjelić et al. (2009) conducted a review in Perioperative fluid balance. Haemodynamic monitoring was evaluated. Rigorous haemodynamic monitoring for perioperative fluid balance reduces mortality, length of stay, and costs, with new minimally invasive techniques increasingly replacing pulmonary artery catheters.
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