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Perioperative Application of Less
Invasive Hemodynamic Monitoring

Yoshifumi Kotake, MD, PhD
Toho University, Tokyo, Japan


1. Perioperative application of less invasive hemodynamic monitoring
2. Today’s agenda
3. Why hemodynamic monitoring?
4. Frank-Starling curve
5. The purpose of hemodynamic monitoring
6. Invasive vs. less-invasive hemodynamic monitoring
7. Features of PAC
8. Current status of PAC
9. Is there any indication for cardiac output monitoring in normal patients?
10. Intraoperative fluid management
11. Liberal strategy with less invasive monitoring
12. Evaluation of corrected flow time in oesophageal Doppler
13. Liberal management #1
14. Liberal management #2
15. Liberal management #3
16. Importance of CO monitor-guided fluid management
17. Risks from excessive fluid
18. Restrictive management # 1
19. Restrictive management # 1 cont.
20. Restrictive management # 2
21. Tachycardia worsens outcome
22. Wet, dry or something else?
23. New paradigm for hemodynamic management
24. Guidance of fluid optimization
25. Introduction of APCO (arterial pressure-based CO monitor)
26. APCO Algorithm Principles
27. APCO Algorithm: Determining SV
28. APCO Algorithm: Determining SV cont.
29. APCO Algorithm: Determining SV cont.
30. APCO Summary
31. APCO Summary cont.
32. ScvO2 monitoring provides early warning sign of complications
33. Suggested Applications
34. APCO and fluid management
35. Fluid responsiveness
36. CVP and fluid responsiveness
37. Classical fluid challenge
38. Passive leg raising and fluid responsiveness
39. Stroke volume variation
40. Respiratory variation and fluid responsiveness
41. Respiratory variation and fluid responsiveness
42. Relationship between SVV and CVP
43. Algorithm for SVV based protocol
44. APCO-based goal-directed fluid management
45. Monitors for goal-directed therapy
46. For more evidence-based, individually optimized management
47. Edwards Lifesciences LLC


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Dr. Yoshi Kotake is a paid consultant of Edwards Lifesciences.

Any quotes used in this material are taken from independent third-party publications and are not intended to imply that such third party reviewed or endorsed any of the products of Edwards Lifesciences.
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Stroke Vol Variation PPT
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TJ Gan MD
W McGee ME MHA
Why Cardiac Output?
Y Kotake MD PhD

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