奥地利非心脏手术期间血流动力学监测与管理的当前实践。

Current practices in hemodynamic monitoring and management during non-cardiac surgery in Austria.

作者信息

Gaik C, Paal P, Reuter D A, Wulf H, Vojnar Benjamin

机构信息

Marburg University, Marburg, Germany.

Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Campus Marburg,, Marburg, Germany.

出版信息

BMC Anesthesiol. 2025 Sep 23;25(1):450. doi: 10.1186/s12871-025-03374-7.

DOI:10.1186/s12871-025-03374-7

PMID:40988060

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12455795/

Abstract

BACKGROUND

Intraoperative hemodynamic monitoring has advanced significantly over the past few decades, enhancing patient safety and improving perioperative outcomes. This survey aimed to examine current practices in intraoperative hemodynamic management in Austria.

METHOD

Between January 2024 and February 2024, members of the Austrian Society of Anesthesiology, Resuscitation, and Intensive Care Medicine (ÖGARI) with a registered email address (n = 1,839) were invited to participate in an anonymous web-based survey.

RESULTS

A total of 201 questionnaires were received, of which 177 were fully completed. When using intermittent oscillometry, 40% (71/177) of respondents measure blood pressure every three minutes during anesthesia induction. Nearly 45% (80/177) routinely insert an arterial catheter before anesthesia induction, using mean arterial pressure (MAP) to Guide blood pressure management. While 36% (61/168) consider a MAP of 60 mmHg critically low, 48% (80/168) set the threshold at 65 mmHg. Intraoperative hypotension is predominantly managed at individual discretion by 79% (140/177), while 12% (21/177) follow institutional standardized protocols. A pulse contour analysis monitor is available in 94% (166/177) of respondents, with 49% (87/177) reporting frequent use. Regarding the limited use of advanced hemodynamic monitoring in high-risk non-cardiac surgery patients, 64% (113/177) perceived its added value as too low, while 57% (100/177) cite a lack of experience in interpreting the parameters as a barrier to implementation.

DISCUSSION

This survey among ÖGARI members provides key insights into intraoperative hemodynamic monitoring in Austrian hospitals. The findings suggest that respondents largely follow international recommendations, particularly concerning general blood pressure thresholds, measurement intervals, and indications for advanced hemodynamic monitoring. However, hemodynamic management appear to be only partially standardized, with decisions primarily left to the discretion of the anesthetist.

TRIAL REGISTRATION

The study was prospectively registered in the German Clinical Trials Register (DRKS; registration number DRKS00033181 on December 6, 2023).

摘要

背景

在过去几十年中，术中血流动力学监测取得了显著进展，提高了患者安全性并改善了围手术期结局。本调查旨在研究奥地利术中血流动力学管理的当前实践情况。

方法

在2024年1月至2024年2月期间，邀请了奥地利麻醉学、复苏与重症医学学会（ÖGARI）中拥有注册电子邮件地址的成员（n = 1,839）参与一项基于网络的匿名调查。

结果

共收到201份问卷，其中177份填写完整。在使用间歇性示波法时，40%（71/177）的受访者在麻醉诱导期间每三分钟测量一次血压。近45%（80/177）的人在麻醉诱导前常规插入动脉导管，使用平均动脉压（MAP）来指导血压管理。虽然36%（61/168）的人认为MAP为60 mmHg属于严重低血压，但48%（80/168）的人将阈值设定为65 mmHg。术中低血压主要由79%（140/177）的人根据个人判断进行处理，而12%（21/177）的人遵循机构标准化方案。94%（166/177）的受访者配备了脉搏轮廓分析监测仪，其中49%（87/177）的人报告经常使用。关于在高风险非心脏手术患者中高级血流动力学监测使用有限的情况，64%（113/177）的人认为其附加值过低，而57%（100/177）的人指出缺乏解读参数的经验是实施的障碍。