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Anaes CasesApplied cardiovascular & respiratory physiology

Anaes Cases · Applied cardiovascular & respiratory physiology

Goal-directed haemodynamic therapy in the high-risk patient

The long case — the goal-directed haemodynamic therapy (the GDT) targeting the cardiac index and the DO2. The Fick and the DO2 equations; the arterial-line and the cardiac-output monitoring; the fluid, the inotrope, and the transfusion to optimise the CO, the Hb, and the SaO2; the individualised targets.

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ANZCAFRCAABAEDAIC
Prompt
A 68-year-old man for major bowel surgery with a recent MI. Discuss the haemodynamic strategy to maintain the tissue oxygen delivery.

Presentation

A 68-year-old man, ASA 4, for an open hemicolectomy for the cancer. He had the non-ST-elevation myocardial infarction six weeks ago (treated medically). He has the left ventricular impairment (the ejection fraction of 40 per cent) and the chronic anaemia (the Hb of 95 g/L). Discuss the haemodynamic strategy to maintain the tissue oxygen delivery through the surgery.[41904484]

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References3ShowHide
  1. [2]Mirus M, et al. Hemodynamic monitoring: basic principles. J Clin Monit Comput, 2026.PMID 41493520
  2. [3]Flick M, et al. Personalized hemodynamic management targeting baseline cardiac index. Trials, 2026.PMID 41904483
  3. [41904484]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
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