Clinical practice in intraoperative haemodynamic monitoring in Poland: a point prevalence study in 31 Polish hospitals

Autor: Anna J. Szczepańska, Łukasz J. Krzych, Michał P. Pluta
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Haemodynamic monitoring
Prevalence
perioperative medicine
Hemodynamics
02 engineering and technology
point prevalence cross-sectional study
Critical Care and Intensive Care Medicine
Anesthesiology
Monitoring
Intraoperative

0502 economics and business
0202 electrical engineering
electronic engineering
information engineering

medicine
Humans
RD78.3-87.3
Aged
risk
Perioperative medicine
haemodynamics
business.industry
RC86-88.9
05 social sciences
Hemodynamic Monitoring
020206 networking & telecommunications
Medical emergencies. Critical care. Intensive care. First aid
General Medicine
Perioperative
Middle Aged
Hospitals
Clinical Practice
monitoring
Anesthesiology and Pain Medicine
Blood pressure
Cross-Sectional Studies
Emergency medicine
Population study
050211 marketing
Female
business
Zdroj: Anaesthesiology Intensive Therapy, Vol 52, Iss 2, Pp 97-104 (2020)
ISSN: 1731-2531
1642-5758
Popis: BACKGROUND Appropriate use of haemodynamic monitoring tools facilitates the adjustment of management to the patient's individual needs. The aim of the study was to evaluate clinical practice in intraoperative monitoring of patients undergoing non-cardiac surgical procedures in selected hospitals in Poland. METHODS A point prevalence cross-sectional study was carried out among 587 adult patients of 31 Polish hospitals on April 5th, 2018. The method of monitoring in relation to the estimated individual risk as well as to the type and mode of surgery was analysed. In addition, intraoperative fluid therapy and use of catecholamines were evaluated. RESULTS Basic monitoring based on non-invasive arterial blood pressure measurements was implemented in 562 (96%) patients. More advanced methods of monitoring were used in 25 (4%) patients during moderate- (n = 16) and high-risk (n = 9) procedures, predominantly in high-risk patients (n = 16) and in university hospital settings (n = 21). Patients monitored basically received significantly higher amounts of fluids, i.e. 8.7 (IQR 6.1-12.6) vs. 6.1 (IQR 4.1-8.6) mL kg-1 h-1, respectively (P < 0.001). The most common vasoactive and inotropic drug was ephedrine, administered to 143 (24%) study patients in a dose of 15 mg (IQR 10-25) - without inter-group differences in categories of individual and procedure-related risk. CONCLUSIONS The basic method of haemodynamic monitoring used in the study population was based on non-invasive arterial blood pressure measurements. The advanced tools of intraoperative haemodynamic monitoring were seldom used. Monitoring was not tailored to the perioperative risk.
Databáze: OpenAIRE