Perioperative non-invasive haemodynamic optimisation using photoplethysmography: A randomised controlled trial and meta-analysis

Fischer, Marc-Olivier; Fiant, Antony; Debroczi, Stéphane; Boutros, Mariam; Pasqualini, Léa; Demonchy, Marguerite; Flais, Frédéric; Alvès, Arnaud; Gérard, Jean-Louis; Buléon, Clément; Hanouz, Jean‐Luc

doi:10.1016/j.accpm.2020.03.016

Cited by 10 publications

(5 citation statements)

References 40 publications

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“…Stens et al showed that using ClearSight™ calculated CI, PPV and MAP for GDFT guidance had no impact on postoperative complications [92]. Furthermore, Fischer et al found that in low-risk colorectal patients, using ClearSight™-guided GDFT does not affect hospital length of stay, postoperative mortality, and the total number of complications [93]. Similarly, Davies et al found that ClearSight™-guided GDFT offers no postoperative complication benefits in high-risk patients undergoing hip fracture repair [94].…”

Section: Masimo Radical 7 Pulse Co-oximeter™ For Goal-directed Fluid ...mentioning

confidence: 99%

Current Commonly Used Dynamic Parameters and Monitoring Systems for Perioperative Goal-Directed Fluid Therapy: A Review

Kan¹,

Skaggs²

2023

Yale J Biol Med

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Goal-directed fluid therapy (GDFT) is usually recommended in patients undergoing major surgery and is essential in enhanced recovery after surgery (ERAS) protocols. This fluid regimen is usually guided by dynamic hemodynamic parameters and aims to optimize patients' cardiac output to maximize oxygen delivery to their vital organs. While many studies have shown that GDFT benefits patients perioperatively and can decrease postoperative complications, there is no consensus on which dynamic hemodynamic parameters to guide GDFT with. Furthermore, there are many commercialized hemodynamic monitoring systems to measure these dynamic hemodynamic parameters, and each has its pros and cons. This review will discuss and review the commonly used GDFT dynamic hemodynamic parameters and hemodynamic monitoring systems.

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Section: Masimo Radical 7 Pulse Co-oximeter™ For Goal-directed Fluid ...mentioning

confidence: 99%

Current Commonly Used Dynamic Parameters and Monitoring Systems for Perioperative Goal-Directed Fluid Therapy: A Review

Kan¹,

Skaggs²

2023

Yale J Biol Med

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“…In the operating room, although goal-directed therapy based on invasive pulse contour analysis reduces postoperative morbidity and length of stay [1 ▪▪ ,34], the literature on the impact of cardiac output optimization using finger-cuff technology remains contradictory. A recent randomized controlled trial and meta-analysis showed no difference in clinical outcome when using finger-cuff technology compared to invasive arterial pressure or intermittent blood pressure management [35], but a contemporary large interventional trial highlighted the interest of such an approach to reduce the incidence of intraoperative hypotension or the need for vasopressors, and decrease postoperative morbidity and mortality [36 ▪▪ ]. To the best of our knowledge, there are no interventional data evaluating the interest of noninvasive pulse contour analysis in the specific setting of the intensive care unit.…”

Section: Non-invasive Pulse Wave Analysismentioning

confidence: 99%

Advantages and limitations of noninvasive devices for cardiac output monitoring: a literature review

Ruste

Jacquet-Lagrèze

2023

Current Opinion in Critical Care

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Purpose of reviewIndividualized hemodynamic optimization often requires cardiac output monitoring, mostly for goal-directed therapy in the operating room and fluid responsiveness assessment in the intensive care unit. Different technologies for noninvasive cardiac output determination have become available over the recent years. It is therefore crucial for care providers to be made aware of the advantages and limitations of those different devices for an appropriate use at the bedside.Recent findingsNowadays, different noninvasive technologies exist, each with their advantages and limitations, but none are considered interchangeable with bolus thermodilution. Different clinical studies however, emphasize that the trending ability of such devices allows to guide decisions from care providers, and that their use may be associated with improved prognosis, especially in the operating room. Recent studies have also reported their potential use for hemodynamic optimization in specific populations.SummaryNoninvasive cardiac output monitoring may have a clinical impact on patient outcomes. Further studies are required to evaluate their clinical relevance, notably in the intensive care unit. Noninvasive monitoring opens up the possibility for hemodynamic optimization in specific or low-risk populations, the benefit of which remains to be assessed.

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“…Adequate GDFT for patients undergoing major surgery requires that stroke volume or cardiac output are monitored to assess fluid responsiveness and that an algorithm is designed that will be applied by all members of the anesthesia team. Admittedly, some studies have not demonstrated a beneficial effect of GDFT on patient outcome [21][22][23][24][25]. However, these studies were mainly underpowered and/ or conducted in relatively healthy patients with minimal fluid shift and blood loss [23,24,[26][27][28].…”

Section: Main Textmentioning

confidence: 99%

“…Admittedly, some studies have not demonstrated a beneficial effect of GDFT on patient outcome [21][22][23][24][25]. However, these studies were mainly underpowered and/ or conducted in relatively healthy patients with minimal fluid shift and blood loss [23,24,[26][27][28]. Additionally, compliance to the study protocols must be examined closely when evaluating the results [29].…”

Section: Main Textmentioning

confidence: 99%

Hydroxyethyl starch for perioperative goal-directed fluid therapy in 2020: a narrative review

et al. 2020

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Background: Perioperative fluid managementincluding the type, dose, and timing of administration-directly affects patient outcome after major surgery. The objective of fluid administration is to optimize intravascular fluid status to maintain adequate tissue perfusion. There is continuing controversy around the perioperative use of crystalloid versus colloid fluids. Unfortunately, the importance of fluid volume, which significantly influences the benefit-to-risk ratio of each chosen solution, has often been overlooked in this debate. Main text: The volume of fluid administered during the perioperative period can influence the incidence and severity of postoperative complications. Regrettably, there is still huge variability in fluid administration practices, both intra-and inter-individual, among clinicians. Goal-directed fluid therapy (GDFT), aimed at optimizing flowrelated variables, has been demonstrated to have some clinical benefit and has been recommended by multiple professional societies. However, this approach has failed to achieve widespread adoption. A closed-loop fluid administration system designed to assist anesthesia providers in consistently applying GDFT strategies has recently been developed and tested. Such an approach may change the crystalloid versus colloid debate. Because colloid solutions have a more profound effect on intravascular volume and longer plasma persistence, their use in this more "controlled" context could be associated with a lower fluid balance, and potentially improved patient outcome. Additionally, most studies that have assessed the impact of a GDFT strategy on the outcome of high-risk surgical patients have used hydroxyethyl starch (HES) solutions in their protocols. Some of these studies have demonstrated beneficial effects, while none of them has reported severe complications.

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Perioperative non-invasive haemodynamic optimisation using photoplethysmography: A randomised controlled trial and meta-analysis

Cited by 10 publications

References 40 publications

Current Commonly Used Dynamic Parameters and Monitoring Systems for Perioperative Goal-Directed Fluid Therapy: A Review

Current Commonly Used Dynamic Parameters and Monitoring Systems for Perioperative Goal-Directed Fluid Therapy: A Review

Advantages and limitations of noninvasive devices for cardiac output monitoring: a literature review

Hydroxyethyl starch for perioperative goal-directed fluid therapy in 2020: a narrative review

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