Optimized Fluid Management with ProAQT®

Fluid responsiveness determination

  • Conventional patient monitoring might be misleading (2)
  • Mean arterial pressure (MAP) and central venous pressure (CVP) are unreliable parameters for fluid responsiveness assessment (2,3)
  • Relying solely on MAP or CVP can lead to unfavorable therapy and adverse outcomes due to complications (2,3)
  • ProAQT provides key flow parameters such as CI, SV & SVV that help to accurately determine your patient’s fluid status (2)

Preventable postsurgical complications are increasingly recognized as a major clinical and economic burden as shown by Michard et al. in a study with 204,680 patients (6):

  • PulsioFlex
  • Parameters
  • Studies / Algorithm
  • Literature

PulsioFlex – The modular platform with integrated ProAQT Technolgoy for advanced monitoring

  • Easy, fast and safe setup
  • Less invasive – Works as plug and play expansion of existing standard arterial catheter
  • Automatic start value determination of advanced hemodynamic parameters with optional calibration via CI value from an external source (e.g. echo)

Salzwedel Algorithm for goal directed hemodynamic therapy(2)

 

 

(2) Salzwedel et al., Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study. Crit Care 2013; 17(5): R191.

1. Gustafsson et al., Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Clin Nutr. 2012, 31(6): 783-800.

2. Salzwedel et al., Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study. Crit Care 2013; 17(5): R191.

3. Marik et al., Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med 2013, 41(7): 1774-1781.

4. Adapted from: Rasmussen & Grande, Blood, fluids, and electrolytes in the pediatric trauma patient. Int Anesthesiol Clin. 1994, 32(1): 79-101.

5. Adapted from: Schwaitzberg, Bergman & Harris, A pediatric trauma model of continuous hmorrage. J Pediatr Surg 1988, 23: 605-609.

6. Michard et al., Potential return on investment for implementation of perioperative goal-directed fluid therapy in major surgery: a nationwide database study. Perioper Med 2015, 4(11): 1-8.

7. Adapted from: Bellamy, Wet, dry or something else? Br J Anaesth 2016, 97(6):755-757.

8. Adapted from: Cannesson, Arterial Pressure Variation and Goal-Directed Fluid Therapy. J Cardiothorac Vasc Anesth. 2010, 24(3):487-497.

9. Bruegger et al., Atrial natriuretic peptide induces shedding of endothelial glycocalyx in coronary vascular bed of guinea pig hearts. Am J Physiol Heart Circ Physiol 2005; 289(5):1993-1999.

10. Nygren et al. Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World J Surg 2013, 37: 285–305.

11. Nelson et al., Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations — Part I. Gynecol Oncol. 2016, 140(2): 313-322.

 

PULSION is part of Maquet Getinge Group