Trauzeddel, R. F., Nordine, M., Groesdonk, H. V., Michels, G., Pfister, R., Reuter, D. A., Scheeren, T. W. L., Berger, C. and Treskatsch, S. (2021). Perioperative optimization using hemodynamically focused echocardiography in high-risk patients-A practice guide. Anaesthesist, 70 (9). S. 772 - 785. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-055X

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Abstract

Background The number of high-risk patients undergoing surgery is steadily increasing. In order to maintain and, if necessary, optimize perioperative hemodynamics as well as the oxygen supply to the organs (DO2) in this patient population, a timely assessment of cardiac function and the underlying pathophysiological causes of hemodynamic instability is essential for the anesthesiologist. A variety of hemodynamic monitoring procedures are available for this purpose; however, due to method-immanent limitations they are often not able to directly identify the underlying cause of cardiovascular impairment. Objective To present a stepwise algorithm for a perioperative echocardiography-based hemodynamic optimization in noncardiac surgery high-risk patients. In this context, echocardiography on demand according to international guidelines can be performed under certain conditions (hemodynamic instability, nonresponse to hemodynamic treatment) as well as in the context of a planned intraoperative procedure, mostly as a transesophageal echocardiography. Methods and results Hemodynamically focused echocardiography as a rapidly available bedside method, enables the timely diagnosis and assessment of cardiac filling obstructions, volume status and volume response, right and left heart function, and the function of the heart valves. Conclusion Integrating all echocardiographic findings in a differentiated assessment of the patient's cardiovascular function enables a (patho)physiologically oriented and individualized hemodynamic treatment.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Trauzeddel, R. F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nordine, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Groesdonk, H. V.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Michels, G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfister, R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reuter, D. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheeren, T. W. L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berger, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Treskatsch, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-597871
DOI: 10.1007/s00101-021-00934-7
Journal or Publication Title: Anaesthesist
Volume: 70
Number: 9
Page Range: S. 772 - 785
Date: 2021
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1432-055X
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
AnesthesiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59787

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