Published in:
Open Access
01-06-2019 | Editorial
Phenylephrine-induced recruitable preload from the venous side
Authors:
Rita Jacobs, Stijn Lochy, Manu L. N. G. Malbrain
Published in:
Journal of Clinical Monitoring and Computing
|
Issue 3/2019
Login to get access
Excerpt
During the perioperative period, patients often suffer from hemodynamic instability, especially after major abdominal surgery, due to several pathophysiological processes: anesthetics, hypovolemia, surgical procedure, mechanical ventilation, cardiac co-morbidities and patient positioning [
1]. Over the last decades we have used aggressive fluid resuscitation as a cornerstone in the treatment of shock, however, with only little evidence to support this [
2‐
4]. Much of our current traditions of fluid resuscitation comes from experience in treating the blue stage of spasmodic cholera, where giving large amounts of aqueous and saline injections saved lives [
5]. Ever since, it is deeply incorporated in our culture that shock must always equal hypovolemia. Fluid administration to maintain or restore circulation hence became an integrated part in the care for patients undergoing surgery, but also in critically ill patients admitted to the ICU. …