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J Anesth. 2016 Jun;30(3):526-9. doi: 10.1007/s00540-016-2155-8. Epub 2016 Mar 9.

Hemodynamic monitoring and management in high-risk surgery: a survey among Japanese anesthesiologists.

Author information

1
Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka City, Osaka, 545-8586, Japan. suehirokoichi@yahoo.co.jp.
2
Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA. suehirokoichi@yahoo.co.jp.
3
Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka City, Osaka, 545-8586, Japan.
4
Department of Anesthesiology and Perioperative Care, Erasme University Hospital, Free University of Brussels, Brussels, Belgium.
5
Department of Anesthesiology and Perioperative Care, University of California Irvine, Irvine, CA, USA.
6
Department of Anesthesiology and Intensive Care, Clinique de la Sauvegarde, Lyon, France.
7
Department of Anesthesiology, University of California San Diego, San Diego, CA, USA.
8
Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Abstract

The aim of this study was to assess the current practices of hemodynamic management in high-risk surgical patients among Japanese anesthesiologists. An invitation letter to the survey, which included 35 questions related to hemodynamic monitoring in high-risk surgery, was mailed to every hospital approved by the Japanese Society of Anesthesiologists (JSA) (1260 hospitals). Of the 692 JSA respondents, 573 completed the survey. Despite reporting a high rate of cardiac output (CO) and stroke volume variation (SVV) monitoring in JSA members (70 and 74 %, respectively), fluid goal-directed therapy was poorly implemented in high-risk surgery (7.4 %). Also, 47 % of the JSA respondents did not consistently perform CO optimization. SVV was more commonly used (76 %) as an indicator of volume expansion among JSA respondents, while central venous pressure was less frequently used (48 %). Despite a broader use of advanced hemodynamic monitoring, optimization of CO is still poorly protocolized and applied in Japan. The development of guidelines and protocols for hemodynamic management, including the establishment of strong evidence aimed at improving clinical outcomes, is needed to assist anesthesiologists in more universal adoption of perioperative CO optimization.

KEYWORDS:

Cardiac output; Goal-directed therapy; Hemodynamics; Intraoperative; Survey

PMID:
26961821
DOI:
10.1007/s00540-016-2155-8
[Indexed for MEDLINE]

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