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Hemodynamic monitoring and management of patients undergoing high-risk surgery: a survey among Chinese anesthesiologists.

Chen G, Zuo Y, Yang L, Chung E, Cannesson M - J Biomed Res (2014)

Bottom Line: We found that 91.4% of anesthesiologists monitored invasive arterial pressure, 82.9% monitored central venous pressure (CVP), 13.3% monitored cardiac output (CO), 10.5% monitored mixed venous saturation, and less than 2% monitored pulse pressure variation (PPV) or systolic pressure variation (SPV) during high-risk surgery.Anesthesiologists in China do not own enough attention on hemodynamic parameters such as PPV, SPV and CO during fluid management in high-risk surgical patients.There is a need for improving access to these technologies as well as an opportunity to create guidelines and education for hemodynamic optimization in China.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China. ; Department of Anesthesiology and Perioperative Care, University of California, Irvine, California.

ABSTRACT
Hemodynamic monitoring and optimization improve postoperative outcome during high-risk surgery. However, hemodynamic management practices among Chinese anesthesiologists are largely unknown. This study sought to evaluate the current intraoperative hemodynamic management practices for high-risk surgery patients in China. From September 2010 to November 2011, we surveyed anesthesiologists working in the operating rooms of 265 hospitals representing 28 Chinese provinces. All questionnaires were distributed to department chairs of anesthesiology or practicing anesthesiologists. Once completed, the 29-item questionnaires were collected and analyzed. Two hundred and 10 questionnaires from 265 hospitals in China were collected. We found that 91.4% of anesthesiologists monitored invasive arterial pressure, 82.9% monitored central venous pressure (CVP), 13.3% monitored cardiac output (CO), 10.5% monitored mixed venous saturation, and less than 2% monitored pulse pressure variation (PPV) or systolic pressure variation (SPV) during high-risk surgery. The majority (88%) of anesthesiologists relied on clinical experience as an indicator for volume expansion and more than 80% relied on blood pressure, CVP and urine output. Anesthesiologists in China do not own enough attention on hemodynamic parameters such as PPV, SPV and CO during fluid management in high-risk surgical patients. The lack of CO monitoring may be attributed largely to the limited access to technologies, the cost of the devices and the lack of education on how to use them. There is a need for improving access to these technologies as well as an opportunity to create guidelines and education for hemodynamic optimization in China.

No MeSH data available.


Top choice for volume expansion
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f04: Top choice for volume expansion

Mentions: Hydroxyethylstarch solution is the first line therapy used by surveyed anesthesiologists in China (65.7%) (Fig. 4). Almost all (94.3%) believe that oxygen delivery to the tissues is of major importance in patients during high risk surgery. When asked which parameters were involved in oxygen delivery to tissues, the replies were hemoglobin (91.4%), CO (75.7%), PaO2 (71.4%), SaO2 (65.7%), arterial pressure (60%) and CVP (11.7%). Ninety percent of them believed that their current hemodynamic management could be improved.


Hemodynamic monitoring and management of patients undergoing high-risk surgery: a survey among Chinese anesthesiologists.

Chen G, Zuo Y, Yang L, Chung E, Cannesson M - J Biomed Res (2014)

Top choice for volume expansion
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4197388&req=5

f04: Top choice for volume expansion
Mentions: Hydroxyethylstarch solution is the first line therapy used by surveyed anesthesiologists in China (65.7%) (Fig. 4). Almost all (94.3%) believe that oxygen delivery to the tissues is of major importance in patients during high risk surgery. When asked which parameters were involved in oxygen delivery to tissues, the replies were hemoglobin (91.4%), CO (75.7%), PaO2 (71.4%), SaO2 (65.7%), arterial pressure (60%) and CVP (11.7%). Ninety percent of them believed that their current hemodynamic management could be improved.

Bottom Line: We found that 91.4% of anesthesiologists monitored invasive arterial pressure, 82.9% monitored central venous pressure (CVP), 13.3% monitored cardiac output (CO), 10.5% monitored mixed venous saturation, and less than 2% monitored pulse pressure variation (PPV) or systolic pressure variation (SPV) during high-risk surgery.Anesthesiologists in China do not own enough attention on hemodynamic parameters such as PPV, SPV and CO during fluid management in high-risk surgical patients.There is a need for improving access to these technologies as well as an opportunity to create guidelines and education for hemodynamic optimization in China.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China. ; Department of Anesthesiology and Perioperative Care, University of California, Irvine, California.

ABSTRACT
Hemodynamic monitoring and optimization improve postoperative outcome during high-risk surgery. However, hemodynamic management practices among Chinese anesthesiologists are largely unknown. This study sought to evaluate the current intraoperative hemodynamic management practices for high-risk surgery patients in China. From September 2010 to November 2011, we surveyed anesthesiologists working in the operating rooms of 265 hospitals representing 28 Chinese provinces. All questionnaires were distributed to department chairs of anesthesiology or practicing anesthesiologists. Once completed, the 29-item questionnaires were collected and analyzed. Two hundred and 10 questionnaires from 265 hospitals in China were collected. We found that 91.4% of anesthesiologists monitored invasive arterial pressure, 82.9% monitored central venous pressure (CVP), 13.3% monitored cardiac output (CO), 10.5% monitored mixed venous saturation, and less than 2% monitored pulse pressure variation (PPV) or systolic pressure variation (SPV) during high-risk surgery. The majority (88%) of anesthesiologists relied on clinical experience as an indicator for volume expansion and more than 80% relied on blood pressure, CVP and urine output. Anesthesiologists in China do not own enough attention on hemodynamic parameters such as PPV, SPV and CO during fluid management in high-risk surgical patients. The lack of CO monitoring may be attributed largely to the limited access to technologies, the cost of the devices and the lack of education on how to use them. There is a need for improving access to these technologies as well as an opportunity to create guidelines and education for hemodynamic optimization in China.

No MeSH data available.