Literature DB >> 26658176

Goal-directed therapy in the operating room: is there any benefit?

Jason B O'Neal1, Andrew D Shaw.   

Abstract

PURPOSE OF REVIEW: This article reviews the current evidence behind goal-directed therapy (GDT) in multiple medical settings. RECENT
FINDINGS: Although some studies advocate for the use of GDT, others do not and more studies are necessary to evaluate the efficacy of GDT in medicine. Previously accepted guidelines for treating patients in septic shock which include GDT in their algorithms are not supported by the findings in recent randomized, controlled trials. No generally accepted guidelines for GDT are available for perioperative use, but there is evidence supporting GDT in high-risk surgery such as major abdominal surgery and cardiac surgery. Clinicians should be aware of the potential benefits of GDT in these settings and use these evidence-based findings to help guide clinical decisions in these patient populations.
SUMMARY: The use of GDT may be beneficial depending on the clinical setting, but more evidence supporting its use is necessary before it can be considered standard of care.

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Mesh:

Year:  2016        PMID: 26658176      PMCID: PMC5687074          DOI: 10.1097/ACO.0000000000000273

Source DB:  PubMed          Journal:  Curr Opin Anaesthesiol        ISSN: 0952-7907            Impact factor:   2.706


  20 in total

1.  Single transpulmonary thermodilution and continuous monitoring of central venous oxygen saturation during off-pump coronary surgery.

Authors:  A A Smetkin; M Y Kirov; V V Kuzkov; A I Lenkin; A V Eremeev; V Y Slastilin; V V Borodin; L J Bjertnaes
Journal:  Acta Anaesthesiol Scand       Date:  2009-01-15       Impact factor: 2.105

Review 2.  Haemodynamic goal-directed therapy in cardiac and vascular surgery. A systematic review and meta-analysis.

Authors:  Mariateresa Giglio; Lidia Dalfino; Filomena Puntillo; Giovanni Rubino; Massimo Marucci; Nicola Brienza
Journal:  Interact Cardiovasc Thorac Surg       Date:  2012-07-24

3.  A randomized trial of protocol-based care for early septic shock.

Authors:  Donald M Yealy; John A Kellum; David T Huang; Amber E Barnato; Lisa A Weissfeld; Francis Pike; Thomas Terndrup; Henry E Wang; Peter C Hou; Frank LoVecchio; Michael R Filbin; Nathan I Shapiro; Derek C Angus
Journal:  N Engl J Med       Date:  2014-03-18       Impact factor: 91.245

4.  Early goal-directed therapy based on endotracheal bioimpedance cardiography: a prospective, randomized controlled study in coronary surgery.

Authors:  Jean-Luc Fellahi; David Brossier; Fabien Dechanet; Marc-Olivier Fischer; Vladimir Saplacan; Jean-Louis Gérard; Jean-Luc Hanouz
Journal:  J Clin Monit Comput       Date:  2014-11-09       Impact factor: 2.502

5.  A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients.

Authors:  P Pölönen; E Ruokonen; M Hippeläinen; M Pöyhönen; J Takala
Journal:  Anesth Analg       Date:  2000-05       Impact factor: 5.108

6.  Randomised controlled trial assessing the impact of a nurse delivered, flow monitored protocol for optimisation of circulatory status after cardiac surgery.

Authors:  Moira McKendry; Helen McGloin; Debbie Saberi; Libby Caudwell; Anthony R Brady; Mervyn Singer
Journal:  BMJ       Date:  2004-07-08

7.  Perioperative goal-directed hemodynamic optimization using noninvasive cardiac output monitoring in major abdominal surgery: a prospective, randomized, multicenter, pragmatic trial: POEMAS Study (PeriOperative goal-directed thErapy in Major Abdominal Surgery).

Authors:  David Pestaña; Elena Espinosa; Arieh Eden; Diana Nájera; Luis Collar; César Aldecoa; Eva Higuera; Soledad Escribano; Dmitri Bystritski; Javier Pascual; Pilar Fernández-Garijo; Blanca de Prada; Alfonso Muriel; Reuven Pizov
Journal:  Anesth Analg       Date:  2014-09       Impact factor: 5.108

8.  Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery.

Authors:  M G Mythen; A R Webb
Journal:  Arch Surg       Date:  1995-04

9.  Effect of a perioperative, cardiac output-guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: a randomized clinical trial and systematic review.

Authors:  Rupert M Pearse; David A Harrison; Neil MacDonald; Michael A Gillies; Mark Blunt; Gareth Ackland; Michael P W Grocott; Aoife Ahern; Kathryn Griggs; Rachael Scott; Charles Hinds; Kathryn Rowan
Journal:  JAMA       Date:  2014-06-04       Impact factor: 56.272

10.  The effects of goal-directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials.

Authors:  Jan Benes; Mariateresa Giglio; Nicola Brienza; Frederic Michard
Journal:  Crit Care       Date:  2014-10-28       Impact factor: 9.097

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  4 in total

1.  Predictive values of pulse pressure variation and stroke volume variation for fluid responsiveness in patients with pneumoperitoneum.

Authors:  Marko Zlicar; Vesna Novak-Jankovic; Rok Blagus; Maurizio Cecconi
Journal:  J Clin Monit Comput       Date:  2017-11-17       Impact factor: 2.502

2.  Goal-directed Therapy: Does It Work in Postcardiac Surgery Patients, Unlike in Sepsis?

Authors:  Sonali Saraf; Dilip R Karnad
Journal:  Indian J Crit Care Med       Date:  2020-05

3.  Effectiveness of architectural separation of septic and aseptic operating theatres for improving process quality and patient outcomes: a systematic review.

Authors:  Romy Scholz; Alexander Hönning; Julia Seifert; Nikolai Spranger; Dirk Stengel
Journal:  Syst Rev       Date:  2019-01-09

4.  Controversies in enhanced recovery after cardiac surgery.

Authors:  Andrew D Shaw; Nicole R Guinn; Jessica K Brown; Rakesh C Arora; Kevin W Lobdell; Michael C Grant; Tong J Gan; Daniel T Engelman
Journal:  Perioper Med (Lond)       Date:  2022-04-28
  4 in total

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