Lorenzen Ulf, Grünewald Matthias
Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2022 Apr;57(4):246-262. doi: 10.1055/a-1472-4285. Epub 2022 Apr 21.
Goal directed hemodynamic monitoring and the balance in goal directed therapy between adequate fluid/volume therapy and the application of vasoactive or inotropic drugs are the basic elements of modern perioperative therapy.Surgical procedures should be accompanied by as few side effects and complications as possible. Nevertheless, the number of postoperative complications remains surprisingly high, despite of the modern surgical procedures. Anticipation of potential complications in the perioperative period and their rapid treatment build a core competence of anesthesiological action. Thus, it is clear that anesthesia plays a central role in this balancing act.This article aims to provide an overview of the application of the currently available perioperative goal directed hemodynamic monitoring. The current possibilities are discussed by using a case example and an outlook on the future of hemodynamic monitoring is given.
目标导向的血流动力学监测以及目标导向治疗中在充分的液体/容量治疗与应用血管活性药物或正性肌力药物之间的平衡是现代围手术期治疗的基本要素。外科手术应伴随尽可能少的副作用和并发症。然而,尽管有现代外科手术方法,术后并发症的数量仍然高得惊人。围手术期对潜在并发症的预测及其快速治疗是麻醉学行动的核心能力。因此,很明显麻醉在这一平衡行为中起着核心作用。本文旨在概述当前可用的围手术期目标导向血流动力学监测的应用。通过一个病例实例讨论当前的可能性,并对血流动力学监测的未来进行展望。