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Journal of Clinical Monitoring and Computing
Published in: Journal of Clinical Monitoring and Computing 1/2019

01-02-2019 | Editorial

Implementation of goal-directed therapy needs a boost, and it is called assisted fluid management

Author: Paul A. van Beest

Published in: Journal of Clinical Monitoring and Computing | Issue 1/2019

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Excerpt

It is a fact of life: implementation of something new, anything new at all, on the work floor is challenging. Even when your new protocol is as evidence based as a new protocol can be, implementation demands perseverance. One of the reasons for this difficulty is that changing behavior without the presence of logistical, procedural, or technical errors on the work floor does not motivate clinical collectives to action [1]. To make behavioral and professional change possible clinicians should be taught about the why, what (how) and when a certain new protocol or device will be implemented. Repetitive teaching and communication is key. …
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Gan TJ, Soppitt A, Maroof M, El-Moalem H, Robertson KM, Moretti E, Dwane P. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology 2002;97:820–6.CrossRefPubMed
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Scheeren TWL, Wiesenack CH. Goal-directed intraoperative fluid therapy guided by stroke volume and its variation in high-risk surgical patients: a prospective randomized multicenter study. J Clin Monit Comput. 2013;27:225–33.CrossRefPubMed
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Benes J, Giglio M, Brienza N, Michard F. The effects of goal-directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials. Crit Care. 2014;18(5):584.CrossRefPubMedPubMedCentral
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Michard F, Giglio MT, Brienza N. Perioperative goal-directed therapy with uncalibrated pulse contour methods: impact on fluid management and postoperative outcome. Br J Anaesth. 2017;119(1):22–30.CrossRefPubMed
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Cannesson M, Ramsingh D, Rinehart J, Demirjian A, Vu T, Vakharia S, Imagawa D, Yu Z, Greenfield S, Kain Z. Perioperative goal-directed therapy and postoperative outcomes in patients undergoing high-risk abdominal surgery: a historical-prospective, comparative effectiveness study. Crit Care. 2015;19:261.CrossRefPubMedPubMedCentral
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Joosten A, Hafiane R, Pustetto M, Van Obbergh L, Quackels TH, Buggenhout A, Vincent JL, Ickx B, Rinehart J. Practical impact of a decision support for goal-directed fluid therapy on protocol adherence: a clinical implementation study in patients undergoing major abdominal surgery. J Clin Monit Comput. 2018.
Metadata
Title
Implementation of goal-directed therapy needs a boost, and it is called assisted fluid management
Author
Paul A. van Beest
Publication date
01-02-2019
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 1/2019
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-018-0155-y

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