4.6 Editorial Material

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

Journal

BRITISH JOURNAL OF ANAESTHESIA
Volume 130, Issue 4, Pages 390-393

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.bja.2022.12.022

Keywords

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

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'Goal-directed haemodynamic therapy' refers to different treatment strategies that adjust interventions based on predefined haemodynamic targets. However, these strategies differ significantly in terms of the underlying target variables and values, potentially leading to different treatment outcomes. Therefore, it is an oversimplification to lump diverse and complex haemodynamic treatment strategies under the term 'goal-directed haemodynamic therapy', and we should refrain from using this imprecise umbrella term.
' 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.

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