Anaesthesia, critical care & pain medicine · 2025
Perioperative hemodynamic optimization - Adults including obstetrics.
СтатьяКлинические рекомендацииНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Fellahi Jean-Luc, Biais Matthieu, Abou-Arab Osama, Beaussier Marc, Cholley Bernard, Chousterman Benjamin, Constant Isabelle, Desebbe Olivier, Ecoffey Claude, Futier Emmanuel, Gayat Etienne, Estevez Max Gonzalez, Guinot Pierre-Grégoire, Jacquet-Lagreze Matthias, Joosten Alexandre, Julien-Marsollier Florence, Lilot Marc, Longrois Dan, Lorne Emmanuel, Losser Marie-Reine, Matezak Marie-Pierre, Mercier Frédéric J, Meuret Ludovic, Moussa Mouhammed, Mrozek Ségolène, Roger Claire, Tavernier Benoît, Fischer Marc-Olivier, Blet Alice
Аннотация
OBJECTIVE: The Société Française d'Anesthesésie et de Réanimation (SFAR) (French Society for Anaesthesia and Intensive Care) is proposing a set of guidelines for perioperative hemodynamic optimisation.
DESIGN: A committee of 27 experts was set up. Policy of declaring and monitoring links of interest was applied and respected throughout the process of producing the reference system. Similarly, it did not receive any funding from a company marketing a health product (drug or medical device). The committee had to respect and follow the GRADE® (Grading of Recommendations Assessment, Development and Evaluation) method to assess the quality of the evidence on which the guidelines were based.
METHODS: The latest SFAR guidelines on perioperative intravascular fluid loading strategy were published in 2012. We wished to update these guidelines after analysing the literature using GRADE® methodology, identifying 5 major fields: arterial pressure, systolic ejection volume and dynamic indices, tissue perfusion indices, volume expansion (excluding transfusion) and/or vasopressors and/or inotropes, and economic impact. Each question was formulated using the PICO (Patients, Intervention, Comparison, Outcome) format.
RESULTS: The experts' summary work and the application of the GRADE method resulted in 24 guidelines. Among the guidelines, 2 have a high level of evidence (GRADE 1) and 8 a low level of evidence (GRADE 2). As the GRADE method could not be applied to 8 questions, the guidelines were based on expert opinion. It was not possible to reach a decision on 6 other questions.
CONCLUSION: 24 guidelines on perioperative haemodynamic optimization have been formulated, with a high degree of agreement between experts.
DESIGN: A committee of 27 experts was set up. Policy of declaring and monitoring links of interest was applied and respected throughout the process of producing the reference system. Similarly, it did not receive any funding from a company marketing a health product (drug or medical device). The committee had to respect and follow the GRADE® (Grading of Recommendations Assessment, Development and Evaluation) method to assess the quality of the evidence on which the guidelines were based.
METHODS: The latest SFAR guidelines on perioperative intravascular fluid loading strategy were published in 2012. We wished to update these guidelines after analysing the literature using GRADE® methodology, identifying 5 major fields: arterial pressure, systolic ejection volume and dynamic indices, tissue perfusion indices, volume expansion (excluding transfusion) and/or vasopressors and/or inotropes, and economic impact. Each question was formulated using the PICO (Patients, Intervention, Comparison, Outcome) format.
RESULTS: The experts' summary work and the application of the GRADE method resulted in 24 guidelines. Among the guidelines, 2 have a high level of evidence (GRADE 1) and 8 a low level of evidence (GRADE 2). As the GRADE method could not be applied to 8 questions, the guidelines were based on expert opinion. It was not possible to reach a decision on 6 other questions.
CONCLUSION: 24 guidelines on perioperative haemodynamic optimization have been formulated, with a high degree of agreement between experts.