scholarly journals Current Practice in Goal-Directed Therapy Protocol among Japanese Anesthesiologists：A Survey about Hemodynamic Monitoring and Management in High-risk Surgery

2017 ◽  
Vol 37 (2) ◽  
pp. 211-218
Author(s):  
Koichi SUEHIRO ◽  
Katsuaki TANAKA ◽  
Kiyonobu NISHIKAWA
Keyword(s):  
High Risk ◽  
Hemodynamic Monitoring ◽  
Current Practice ◽  
Goal Directed Therapy ◽  
Therapy Protocol

scholarly journals The effect of compliance with a perioperative goal-directed therapy protocol on outcomes after high-risk surgery: a before-after study

2020 ◽  
Author(s):  
M. F. Boekel ◽  
C. S. Venema ◽  
T. Kaufmann ◽  
I. C. C. van der Horst ◽  
J. J. Vos ◽  
...  
Keyword(s):  
High Risk ◽  
Stroke Volume ◽  
Stroke Volume Variation ◽  
Stroke Volume Index ◽  
Postoperative Outcomes ◽  
Volume Index ◽  
Goal Directed Therapy ◽  
Volume Variation ◽  
Protocol Compliance ◽  
Therapy Protocol

Abstract Perioperative goal-directed therapy is considered to improve patient outcomes after high-risk surgery. The association of compliance with perioperative goal-directed therapy protocols and postoperative outcomes is unclear. The purpose of this study is to determine the effect of protocol compliance on postoperative outcomes following high-risk surgery, after implementation of a perioperative goal-directed therapy protocol. Through a before-after study design, patients undergoing elective high-risk surgery before (before-group) and after implementation of a perioperative goal-directed therapy protocol (after-group) were included. Perioperative goal-directed therapy in the after-group consisted of optimized stroke volume variation or stroke volume index and optimized cardiac index. Additionally, the association of protocol compliance with postoperative complications when using perioperative goal-directed therapy was assessed. High protocol compliance was defined as ≥ 85% of the procedure time spent within the individual targets. The difference in complications during the first 30 postoperative days before and after implementation of the protocol was assessed. In the before-group, 214 patients were included and 193 patients in the after-group. The number of complications was higher in the before-group compared to the after-group (n = 414 vs. 282; p = 0.031). In the after-group, patients with high protocol compliance for stroke volume variation or stroke volume index had less complications compared to patients with low protocol compliance for stroke volume variation or stroke volume index (n = 187 vs. 90; p = 0.01). Protocol compliance by the attending clinicians is essential and should be monitored to facilitate an improvement in postoperative outcomes desired by the implementation of perioperative goal-directed therapy protocols.

scholarly journals Current practice in hemodynamic monitoring and management in high-risk surgery patients: a national survey of Korean anesthesiologists

2013 ◽  
Vol 65 (1) ◽  
pp. 19 ◽  
Author(s):  
Sang-Hyun Kim ◽  
Min-Jae Kim ◽  
Joon-Ho Lee ◽  
Sung-Hwan Cho ◽  
Won-Seok Chae ◽  
...  
Keyword(s):  
High Risk ◽  
National Survey ◽  
Hemodynamic Monitoring ◽  
Current Practice

scholarly journals Review: Combination therapy in high-risk stage II or stage III colon cancer: current practice and future prospects

2010 ◽  
Vol 2 (4) ◽  
pp. 261-272 ◽  
Author(s):  
Diogo Assed Bastos ◽  
Suilane Coelho Ribeiro ◽  
Daniela de Freitas ◽  
Paulo M. Hoff
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Combination Therapy ◽  
Current Practice ◽  
Stage Ii ◽  
Stage Iii ◽  
Future Prospects ◽  
Stage Iii Colon Cancer

Implementing a Goal-Directed Therapy Protocol for Fluid Resuscitation in the Cardiovascular Intensive Care Unit

2020 ◽  
Vol 31 (4) ◽  
pp. 364-370
Author(s):  
Lori Dugan Brien ◽  
Marilyn H. Oermann ◽  
Margory Molloy ◽  
Catherine Tierney
Keyword(s):  
Fluid Resuscitation ◽  
Simulation Training ◽  
Kidney Injury ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Intravenous Fluids ◽  
Goal Directed Therapy ◽  
Cardiovascular Intensive Care ◽  
Vasoactive Medications ◽  
Therapy Protocol

Background Balancing fluid administration and titration of vasoactive medications is critical to preventing postoperative complications in cardiac surgical patients. Objective To evaluate the impact of implementing a goal-directed therapy protocol in the cardiovascular intensive care unit on total intravenous fluids administered on the day of surgery, rates of acute kidney injury, and hospital length of stay. Methods A fluid resuscitation protocol using dynamic assessment of fluid responsiveness with stroke volume index was developed, and nurses were prepared for its implementation using simulation training. Results After implementation of the new protocol, the total amount of intravenous fluids administered on the day of surgery was significantly reduced (P = .003). There were no significant changes in hospital length of stay (P = .83) or rates of acute kidney injury (P = .86). There were significant increases in nurses’ knowledge of (P < .001) and confidence in (P < .001) fluid resuscitation and titration of vasoactive medications after simulation training. Conclusions Use of a fluid resuscitation protocol resulted in a reduction in the amount of intravenous fluids administered on the day of surgery. The simulation training increased nurses’ knowledge of and confidence in fluid resuscitation and titration of vasoactive medications.

Measurement of Bone Mineral Density

1998 ◽  
Vol 4 (2) ◽  
pp. 73-76
Author(s):  
Nicola Peel
Keyword(s):  
High Risk ◽  
Current Practice ◽  
Standard Technique ◽  
Therapeutic Strategies ◽  
Response To Treatment ◽  
Mineral Density ◽  
X Ray ◽  
Further Development ◽  
Risk Categories ◽  
Gold Standard Technique

The development of techniques to measure BMD enables individuals at high risk of osteoporotic fracture to be identified, and their response to treatment to be ascertained. Measurement of the spine and proximal femur by DXA is currently the gold standard technique, but peripheral skeletal measurements using QUS and x-ray based techniques are under evaluation. At the present time measurements should be targeted to individuals within high risk categories in whom knowledge of BMD may influence management. Further development of both diagnostic and therapeutic strategies will require modification of current practice in the future.

Sign in / Sign up

Export Citation Format

Share Document