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Targeted Volume Management The right amount of the right fluid at the right time

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The right amount of the right fluid at the right time The CardioQ-ODM in Surgery A unique solution Problem Solution Tool Technology Evidence Level 1 grade A ... – PowerPoint PPT presentation

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Title: Targeted Volume Management The right amount of the right fluid at the right time


1
Targeted Volume ManagementThe right amount of
the right fluid at the right time
  • The CardioQ-ODM in Surgery
  • A unique solution

2
Problem
  • Why?
  • Nil by mouth
  • Anaesthetic
  • Surgery

Hypovolaemia the primary cause of
non-surgical post-operative complications
3
Solution
  • Why?
  • Fuller recovery
  • Faster recovery
  • Home earlier

4
Tool
  • Why?
  • Its easy
  • Its safe
  • It works

5
Technology
  • Intervene
  • Early
  • Quickly
  • Safely

6
Evidence
  • Level 1 grade A evidence demonstrates that TVM
    using ODM
  • Improves the quality of recovery
  • Reduces complications
  • Reduces length of hospital stay
  • Reduces critical care demand

Good for all, crucial for some
7
RCTs in Major Surgery
8
RCTs in Major Surgery
0
9
Unique Evidence Base
  • The only intra-operative haemodynamic monitor
  • Proven in multiple RCTs to reduce complications
    and shorten lengths of hospital stay
  • Subject to 3 independent meta-analyses
  • Subject to 2 independent Health Technology
    Assessments

10
Why does it work?
11
The right amount of the right fluid at the right
time
12
The Aims of TVM
  • To achieve optimal filling of the vascular system
  • Eliminate hypovolaemia
  • Optimise oxygen delivery
  • To avoid excess crystalloid use
  • Avoid tissue oedema
  • Avoid adverse impact of chloride on gut

13
Key Components of TVM
  • Delivery of appropriate crystalloid volumes for
    maintenance
  • Oesophageal Doppler-guided stroke volume
    optimisation using colloids to eliminate
    hypovolaemia

- Better outcomes - Faster, fuller recovery -
Earlier home
14
Is it worth it?
  • Surgical teams that do this
  • Have lower mortality rates
  • Have lower readmission rates
  • Have shorter lengths of stay

15
TVM in Evidence-based Protocols
16
Targeted Volume Management
The right amount of the right fluid at the right
time
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