Grünewald Matthias, Broch Ole, Bein Berthold
Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel. Seine Schwerpunkte sind: Anästhesiologisches Monitoring, Post-Reanimationstherapie, klinische Studien.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2012 Jul;47(7-8):490-7; quiz 498. doi: 10.1055/s-0032-1323569. Epub 2012 Aug 23.
Goal-directed fluid therapy (GDT) is one important step in perioperative therapy as it improves complication rate and mortality by optimisation of oxygen delivery. There is a convincing evidence for GDT when used early, before organ failure occurs, and in high-risk patients. Moderne algorithms use goals derived from advanced haemodynamic monitoring and are based on the concept of fluid responsiveness and optimisation of global perfusion. Future investigations will have to prove the advantage of using the new less or non-invasive haemodynamic monitoring devices or automatic closed-loop fluid administration systems for GDT.
目标导向液体治疗(GDT)是围手术期治疗的重要一步,因为它通过优化氧输送来降低并发症发生率和死亡率。有令人信服的证据表明,在器官功能衰竭发生之前早期使用GDT以及在高危患者中使用GDT是有效的。现代算法采用源自先进血流动力学监测的目标,并基于液体反应性和整体灌注优化的概念。未来的研究将必须证明使用新型较少或非侵入性血流动力学监测设备或自动闭环液体给药系统进行GDT的优势。