Goal-directed therapy: what is the goal again?
Abstract Recent attention has focused on intraoperative hypotension (IOH) and hemodynamic instability. This enhanced awareness to limit IOH, combined with fluid restriction and increased vasopressor use, has been associated with an increase in postoperative acute kidney injury. Recent literature sup...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Perioperative Medicine |
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| Online Access: | https://doi.org/10.1186/s13741-025-00533-9 |
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| _version_ | 1850154839692017664 |
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| author | Amy Yerdon Ken Taylor Katie Woodfin Ryan Richey Susan McMullan Desirée Chappell |
| author_facet | Amy Yerdon Ken Taylor Katie Woodfin Ryan Richey Susan McMullan Desirée Chappell |
| author_sort | Amy Yerdon |
| collection | DOAJ |
| description | Abstract Recent attention has focused on intraoperative hypotension (IOH) and hemodynamic instability. This enhanced awareness to limit IOH, combined with fluid restriction and increased vasopressor use, has been associated with an increase in postoperative acute kidney injury. Recent literature supports improved intraoperative monitoring of mean arterial pressure (MAP), fluid management, and appropriate use of vasopressors and inotropic support for hemodynamic management. Implementing an algorithm to manage the causes of IOH minimizes iatrogenic harm by guiding anesthesia clinicians to select the appropriate interventions at the optimal time. This ensures a comprehensive evaluation of contributing factors such as fluid deficits, myocardial depression, and vasodilation. Shifting attention from the MAP displayed on the physiologic monitor to more individualized care with a goal-directed therapy approach may improve patient outcomes. |
| format | Article |
| id | doaj-art-041a8faced154da38406ea54e5e52364 |
| institution | OA Journals |
| issn | 2047-0525 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj-art-041a8faced154da38406ea54e5e523642025-08-20T02:25:11ZengBMCPerioperative Medicine2047-05252025-05-0114111010.1186/s13741-025-00533-9Goal-directed therapy: what is the goal again?Amy Yerdon0Ken Taylor1Katie Woodfin2Ryan Richey3Susan McMullan4Desirée Chappell5University of Alabama at Birmingham BSN-DNP Nurse Anesthesia Pathway St. Vincent’s East Hospital in Birmingham University of Alabama at Birmingham BSN-DNP Nurse Anesthesia PathwayUniversity of Alabama at Birmingham BSN-DNP Nurse Anesthesia PathwayUniversity of Alabama at Birmingham BSN-DNP Nurse Anesthesia PathwayNorthstar AnesthesiaAbstract Recent attention has focused on intraoperative hypotension (IOH) and hemodynamic instability. This enhanced awareness to limit IOH, combined with fluid restriction and increased vasopressor use, has been associated with an increase in postoperative acute kidney injury. Recent literature supports improved intraoperative monitoring of mean arterial pressure (MAP), fluid management, and appropriate use of vasopressors and inotropic support for hemodynamic management. Implementing an algorithm to manage the causes of IOH minimizes iatrogenic harm by guiding anesthesia clinicians to select the appropriate interventions at the optimal time. This ensures a comprehensive evaluation of contributing factors such as fluid deficits, myocardial depression, and vasodilation. Shifting attention from the MAP displayed on the physiologic monitor to more individualized care with a goal-directed therapy approach may improve patient outcomes.https://doi.org/10.1186/s13741-025-00533-9Goal-directed therapyHemodynamic instabilityIntraoperative hypotensionHemodynamic managementIndividualized care |
| spellingShingle | Amy Yerdon Ken Taylor Katie Woodfin Ryan Richey Susan McMullan Desirée Chappell Goal-directed therapy: what is the goal again? Perioperative Medicine Goal-directed therapy Hemodynamic instability Intraoperative hypotension Hemodynamic management Individualized care |
| title | Goal-directed therapy: what is the goal again? |
| title_full | Goal-directed therapy: what is the goal again? |
| title_fullStr | Goal-directed therapy: what is the goal again? |
| title_full_unstemmed | Goal-directed therapy: what is the goal again? |
| title_short | Goal-directed therapy: what is the goal again? |
| title_sort | goal directed therapy what is the goal again |
| topic | Goal-directed therapy Hemodynamic instability Intraoperative hypotension Hemodynamic management Individualized care |
| url | https://doi.org/10.1186/s13741-025-00533-9 |
| work_keys_str_mv | AT amyyerdon goaldirectedtherapywhatisthegoalagain AT kentaylor goaldirectedtherapywhatisthegoalagain AT katiewoodfin goaldirectedtherapywhatisthegoalagain AT ryanrichey goaldirectedtherapywhatisthegoalagain AT susanmcmullan goaldirectedtherapywhatisthegoalagain AT desireechappell goaldirectedtherapywhatisthegoalagain |