Non-Invasive Hemodynamic Monitoring for Hemodynamic Management in Perioperative Medicine

摘要

Until recently, the measurement of advanced hemodynamic variables used in GDT protocols required invasive hemodynamic monitoring such as invasive pulse contour analysis (arterial catheter), transpulmonary thermodilution (dedicated arterial catheter and central venous catheter), or pulmonary artery thermodilution (pulmonary artery catheter). However, during the last decades, the use of the pulmonary artery catheter in perioperative medicine and critical care is declining (12, 13) and the routine use of the pulmonary artery catheter is not recommended for surgical patients undergoing non-cardiac surgery (14). Advanced hemodynamic monitoring using the transpulmonary thermodilution technique, often called a less-invasive alternative to the pulmonary artery catheter, is also used only in a minority of patients in the perioperative period (15). Especially in the UK, the esophageal doppler is used to assess blood flow for perioperative GDT (3). Many recent studies on perioperative GDT used un-calibrated invasive pulse contour analysis (arterial catheter) to assess blood pressure, dynamic cardiac preload parameters, or cardiac output (3, 4, 16–18).