医学
血流动力学
围手术期
重症监护医学
静脉输液
麻醉
作者
W. Brenton French,Michael J. Scott
标识
DOI:10.1016/j.anclin.2021.11.002
摘要
Several components of an Enhanced Recovery After Surgery (ERAS) pathway act to improve and simplify perioperative fluid and hemodynamic therapy. Modern perioperative fluid management has shifted away from the liberal fluid therapy and toward more individualized approaches. Clinical evidence has also emphasized the importance of maintaining adequate mean arterial pressure and avoiding intraoperative hypotension. Goal-directed hemodynamic therapy (GDHT), or the use of cardiac output monitoring to guide fluid and vasopressor use, has been shown to reduce complications, but its role within ERAS pathways is likely best-suited to high-risk patients or those undergoing high-risk procedures. This article reviews the mechanisms by which ERAS pathways aid the provider in hemodynamic management, reviews trends, and evidence regarding fluid and hemodynamic therapy approaches, and provides guidance on the practical implementation of these concepts within ERAS pathways.
科研通智能强力驱动
Strongly Powered by AbleSci AI