Goal-directed therapy: What direction is the goal again?-Goal-directed therapy: What direction is the goal again?

Video Transcription

Video Summary

Desiree Chappell and Amy Yerden discuss the importance of goal-directed hemodynamic therapy in improving patient outcomes during surgery. Chappell, a CRNA and podcast co-editor, and Yerden, an assistant professor and clinical practitioner, emphasize understanding how to manage patients' fluid and hemodynamic statuses to prevent complications such as hypotension.<br /><br />They talk about transitioning from traditional fluid management methods, like the 4-2-1 rule, to a more individualized approach using advanced monitoring tools. This includes assessing and optimizing fluid responsiveness through stroke volume variation and pulse pressure variation, which helps tailor fluid administration to individual patient needs.<br /><br />The duo highlights a methodical approach using the fill, flow, and pressure framework, emphasizing cardiac index and systemic vascular resistance to direct use of fluids, inotropes, and vasopressors. They advocate for using advanced hemodynamic monitoring to predict and prevent intraoperative hypotension, thus improving surgical outcomes.<br /><br />Chappell and Yerden support personalized fluid and hemodynamic management based on patient and surgical risk, promoting a shift from reactive to proactive patient care in anesthesia. Their approach aims to reduce reliance on vasopressors and improve patient recovery by focusing on stable hemodynamics and optimized fluid management.

Keywords

hemodynamic therapy

patient outcomes

fluid management

advanced monitoring

stroke volume variation

intraoperative hypotension

personalized care

anesthesia