The Use of Stroke Volume Variation and Arterial Pressure Based Cardiac Output to Guide Intra-operative Volume Resuscitation in Cardiovascular Surgery DRUG & INNOVATION UPDATE

Hemodynamic monitoring is a central aspect in cardiovascular diagnosis and care. Adequate volume replacement to achieve optimal cardiac performance is a primary goal of hemodynamic manage-ment in patients undergoing cardiovascular surgery. However, in only half of such patients, the cardiac output (CO) increases after a fluid challenge and thus only these can be considered as respond-ers to fluid therapy. Therefore, physicians need reliable criteria to distinguish between responders and non-responders to avoid any deleterious consequences of fluid overload. It has been demonstrated that neither the standard preload indices such as central venous pressure (CVP) or pulmonary capillary wedge pressure (PCWP) nor their changes in response to fluid challenges reflect ventricular end-diastolic volumes in patients receiving a fluid challenge for hemodynamic instability, and are not capable of predicting cardiac response to fluid therapy (1). As an alterna