Perioperative Haemodynamic Monitoring during Oncosurgery and Its Utility in the Outcome: A Narrative Review

This is the authors' abstract. We don't add key points for this paper.

All patients undergoing surgery require monitoring for the administration/practice of safe anaesthesia. Patients undergoing supra-major surgeries for cancer often become haemodynamically unstable (or at risk of becoming unstable) owing to hypovolemia, cardiac dysfunction or alterations of vasomotor function, leading to organ dysfunction, deterioration into multi-organ failure and morbidity and even mortality. Haemodynamic monitoring is crucial for assessing and managing patients with circulatory issues, helping to diagnose problems, guide treatment and optimise oxygen delivery to tissues, thus improving patient safety and outcomes. During surgery, various haemodynamic variables are monitored and optimised to maintain organ perfusion pressure and oxygen delivery-and to eventually improve outcomes. Important haemodynamic variables that provide an understanding of most pathophysiologic haemodynamic conditions during surgery include heart rate, arterial pressure, central venous pressure, pulse pressure variation/stroke volume (SV) variation, SV and cardiac output. We therefore revisit the pathophysiologic rationale for intraoperative monitoring of haemodynamic variables and see the current use, and future technological developments of monitoring methods, and finally briefly summarise the evidence that haemodynamic management can improve patient-centred outcomes. Monitoring can be done by several different techniques, and each has its own advantages and disadvantages, which may range from invasive to less invasive and even non-invasive techniques, and could be calibrated or non-calibrated.