Goal-directed haemodynamic therapy: an imprecise umbrella term to avoid

Bernd Saugel; Kristen K Thomsen; Kamal Maheshwari

doi:10.1016/j.bja.2022.12.022

Goal-directed haemodynamic therapy: an imprecise umbrella term to avoid

Br J Anaesth. 2023 Apr;130(4):390-393. doi: 10.1016/j.bja.2022.12.022. Epub 2023 Jan 31.

Authors

Bernd Saugel¹, Kristen K Thomsen², Kamal Maheshwari³

Affiliations

¹ Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Outcomes Research Consortium, Cleveland, OH, USA. Electronic address: [email protected].
² Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.

PMID: 36732140
DOI: 10.1016/j.bja.2022.12.022

Abstract

'Goal-directed haemodynamic therapy' describes various haemodynamic treatment strategies that have in common that interventions are titrated to achieve predefined haemodynamic targets. However, the treatment strategies differ substantially regarding the underlying haemodynamic target variables and target values, and thus presumably have different effects on outcome. It is an over-simplifying approach to lump complex and substantially differing haemodynamic treatment strategies together under the term 'goal-directed haemodynamic therapy', an imprecise umbrella term that we should thus stop using.

Keywords: arterial pressure; blood pressure; cardiac index; cardiac output; goal-directed therapy; haemodynamic monitoring; pulse pressure variation; stroke volume.

Publication types

Editorial
Comment

MeSH terms

Fluid Therapy
Goals*
Hemodynamics*
Humans