The adverse effects of poor haemodynamic management during surgery are not always immediately obvious. In other words, they often only become apparent later in the continuum of care. 

However, complications can be serious, with study after study reporting a high incidence of conditions such as acute renal failure and surgical site infection. This often results in a demand for prolonged care.

The good news is that careful haemodynamic management can prevent complications and help clinicians achieve better outcomes.

Optimisation of stroke volume (SV) is, in its simplest form, the administration of filling fluid guided by an algorithm to normalise SV without the risk of fluid overload. The SV 10% variation algorithm uses Frank-Starling’s law, which establishes the relationship between left ventricular SV and left ventricular end-diastolic volume.

Diagram of stroke volume (SV)

The ODM+ Oesophageal Doppler from Deltex Médical enables clinicians to guide the administration of filling during major, high-risk surgical procedures. When used to guide the intraoperative management of filling fluids, ODM+ has been shown to reduce postoperative complications. 

DELTEX MEDICAL’s TrueVue system, featuring an oesophageal Doppler and pulse pressure waveform analysis technology, is changing the way hospital clinicians can care for surgical and critical care patients. The system is a guide to individualised haemodynamic management. It combines Doppler and pressure parameters, such as Dynamic Arterial Elastance (EaDyn: Delta PP / Delta SV).

DELTEX MEDICAL is a world leader in haemodynamic monitoring and helps clinicians achieve better clinical outcomes every day.

Emergency admission to the operating room for an appendectomy following acute appendicitis:

• Preoperative management of hypotension and tachycardia symptoms caused by infection, pain, and nausea.

• Perioperative management of blood pressure and fluids, with the patient initially presenting vasoconstriction (see top image) after administration of vasopressors prior to surgery.

• Improvement in the patient’s blood flow once vasodilation was achieved (see triangular waveforms in the bottom image), allowing for enhanced cardiac output through careful administration of fluid resuscitation.

The anesthesiologist was satisfied with the patient’s hemodynamic status upon leaving the operating room and highlighted the usefulness of the esophageal Doppler monitor in providing accurate real-time cardiac output data.

• The patient was discharged after an uncomplicated recovery.