TRENDING vital hemodynamic data in the PERIOPERATIVE ENVIRONMENT
Cheetah technologies are ideally suited for hemodynamic monitoring in the operating room – easy to use, fast, reliable, accurate and robust in a challenging and rapidly changing clinical environment.
Enhanced recovery initiatives, including Enhanced Recovery after Surgery (ERAS) and Perioperative Surgical Home (PSH), show the benefit of accurately managing volume throughout the entire perioperative period. Cheetah hemodynamic systems provide data throughout the continuum of care, and ‘follow’ the patient through the OR, the PACU, and to critical care units and general care wards as care dictates.
These enhanced recovery care pathways, designed to reduce surgical costs and complications including mortality and readmission, are being adopted at numerous hospitals throughout the world.
Enhanced Recovery After Surgery (ERAS):
- ERAS protocols have been developed to expedite recovery, minimize complications, and decrease utilization of hospital resources.
- Volume management is a key element of ERAS and perioperative care.
- Perioperative outcomes favor a goal-directed therapy compared to a liberal fluid therapy without hemodynamic goals.1
- Large population based research shows surgical fluid administration is highly variable and associated with inferior outcomes. 2
- Multiple studies conclude that goal-directed fluid therapy reduces complications.1,3,4
Peri-Operative Surgical Home (PSH):
PSH care pathways and protocols have similar objectives to the ERAS programs; however, the PSH initiative follows the patient throughout the entire episode of care from the peri-operative environment to hospital discharge, and may include readmission reduction and out-of-hospital rehab, homecare and education.
Appropriate fluid management is central to the success of both of these care pathways, and Cheetah hemodynamic systems are ideally positioned to provide the important and timely data that is needed to ensure the best transitions along all paths of care.
Cheetah’s 100% noninvasive hemodynamic profile allows Anesthesia and Surgical teams to:
- Obtain advanced hemodynamic parameters throughout the entire continuum of care: Pre-Op, Operating Room, PACU and SICU/Step Down
- Use continuous Stroke Volume (SV) and Cardiac Output (CO) to assist with volume decisions even in the presence of arrhythmias and regardless of ventilation status
- Use changes in Stroke Volume to guide fluid decisions in Enhanced Recovery After Surgery (ERAS) and Perioperative Surgical Home (PSH) protocols
- Trend key hemodynamic parameters through the perioperative period to assess a patient’s fluid responsiveness
- Use advanced hemodynamic measures such as cardiac output, vascular resistance and oxygen delivery to manage and optimize perfusion
Trending Hemodynamic Data with Cheetah Medical Systems
The Cheetah Sensors can be placed without compromising the surgical field, and data is obtained easily and with little training of the perioperative team.
1. Corcoran, Tomas, et al. “Perioperative fluid management strategies in major surgery: a stratified meta-analysis.” Anesthesia & Analgesia3 (2012): 640-651.
2. Thacker, Julie KM, et al. “Perioperative fluid utilization variability and association with outcomes: Considerations for enhanced recovery efforts in sample US surgical populations.” Annals of surgery3 (2016): 502-510.
3. Hamilton, Mark A., Maurizio Cecconi, and Andrew Rhodes. “A systematic review and meta-analysis on the use of preemptive hemodynamic intervention to improve postoperative outcomes in moderate and high-risk surgical patients.” Anesthesia & analgesia6 (2011): 1392-1402.
4. Pearse, Rupert M., et al. “Effect of a perioperative, cardiac output–guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: A randomized clinical trial and systematic review.” Jama21 (2014): 2181-2190.