optimal volume range. The control to reduce variability in
parameters in the OR
used in a clinician-directed PGDT
protocol are key to optimal volume
monitoring solutions that can be utilized perioperatively from the OR to the ICU.
Edwards’ hemodynamic monitoring solutions provide
advanced hemodynamic parameters shown to be more
informative in determining fluid responsiveness than
conventional pressure-based parameters, such as mean
arterial pressure (MAP) and central venous pressure (CVP). 1,2
Each of Edwards’ monitoring solutions offers continuous
dynamic and flow-based information which may be used in
Perioperative Goal-Directed Therapy (PGDT) to
consistently maintain your moderate to high-risk surgery
patients in the optimal volume range. 3
A clinician-directed treatment protocol, which
defines and treats to a goal, using advanced
hemodynamic parameters, with the objective
of consistently maintaining patients in the
optimal volume range during surgery.
Based on the complexity of each procedure, and patient risk factors, choose your preferred dynamic and
flow-based parameters and the appropriate Edwards’ hemodynamic monitoring solution to suit your
clinical approach and your moderate to high-risk surgical patients’ needs.
Edwards delivers an array of product support, tools and educational resources to help you advance patient care by extending
the benefits of reduced variability in volume administration to a broader range of patients, and more moderate
to high-risk surgical procedures.
30+ randomized controlled trials and 14+ meta-analyses have demonstrated clinical benefits of hemodynamic optimization utilizing a PGDT protocol and advanced parameters over standard volume management, including reducing post-surgical complications across a wide range of moderate to high-risk surgical populations. 4-7
Additionally, an extensive body of clinical evidence shows that goal-directed hemodynamic optimization of high-risk patients, initiated in the OR and continued in the ICU, not only improves short-term outcomes, but also increases long-term survival. 8-27
in the optimal volume range.
preload and stroke volume (SV)
Optimal volume management is possible when dynamic and
flow-based parameters are used within a protocol such as
Perioperative Goal-Directed Therapy (PGDT). 3,28-30
Managing volume administration is not the same as
consistently maintaining your patient in the optimal volume
in guiding volume administration.
Deviations from hemodynamic stability may increase with more invasive procedures
and/or more severe clinical conditions. Continuous access to advanced hemodynamic
parameters offers immediate insight into patient physiologic status, giving you the clarity to
make more informed volume administration decisions to help you consistently maintain your
patients in the optimal volume range.3,8,23,25,26,38-42
Conventional volume management, based on standard
monitoring including central venous pressure (CVP), is
Clinical studies have shown CVP is not able to predict fluid
responsiveness1 and that changes in blood pressure cannot
be used to track changes in stroke volume (SV) or in cardiac
output (CO) induced by volume expansion. 2
Stroke Volume Variation (SVV) has demonstrated a higher
sensitivity and specificity in the assessment of circulating
blood volume when compared to conventional indicators of
volume status (HR, MAP, CVP) . 16,20,32
Stroke Volume Optimization (SV) 11,16-19,21-26
Stroke volume measurement with the ClearSight and FloTrac
systems enables an individualized approach for administering
fluid until SV reaches a plateau on the Frank-Starling curve, to
prevent hypovolemia and excessive fluid administration.
Stroke Volume Variation Optimization (SVV) 25
For control-ventilated patients, SVV has proved to be a highly
sensitive and specific indicator for pre-load responsiveness,
serving as an accurate marker of patient status on the
Oxygen Delivery Optimization (DO 2 with CCO) 23
Continuous cardiac output (CCO) measured by the ClearSight
and FloTrac systems can be used (in combination with SaO 2
and hemoglobin) to monitor and optimize DO 2 with fluid
(including red blood cells) and inotropic agents.
|SV protocol studies||Abdominal||Bowel||Cardiac||Cystectomy||General||Hip||Trauma||Vascular|
Currently, literature supports the use of SVV only on patients who are 100% mechanically (control mode) ventilated with tidal volumes of more than 8cc/kg and fixed respiratory rates.
Spontaneous Breathing 35,36
Currently, literature does not support the use of SVV with patients who are spontaneously breathing due to the irregular nature of rate and tidal volumes.
Arrhythmias can dramatically affect SVV values. Thus, the utility of SVV as a guide for volume resuscitation is greatest in absence of arrhythmias.
Increasing levels of positive end expiratory pressure (PEEP) may cause an increase in SVV, the effects of which may be corrected by additional volume resuscitation if warranted.
Vascular Tone 35,36
The effects of vasodilatation therapy may increase SVV and should be considered before treatment with additional volume.
|SVV protocol studies||Abdominal||Abdominal and vascular||Cardiac||Thoracic|
|DO 2 protocol studies||Abdominal||General||General and Vascular||Hepatectomy||Hip||Trauma||Vascular|
valuable insight to help guide volume administration.
offer advanced hemodynamic monitoring,
noninvasively, to a broader range of patients who may
be at risk for post-surgical complications. Learn more
The Swan-Ganz pulmonary artery catheter gives you the clarity of a comprehensive hemodynamic profile delivered by
a single monitoring solution. It allows you to continually assess flow, pressure and oxygen delivery and consumption, to assist your early evaluation. For a continuous view of cardiac function that can enable earlier intervention in your critically complex patients, choose the parameters that best suit your clinical approach and your patient's need. Learn more
The EV1000 clinical platform clearly and simply presents your patient’s physiologic
status, giving you the clarity to make more informed volume administration
decisions. Get continuous access to clinically validated parameters * by using the
EV1000 clinical platform with the ClearSight system , FloTrac sensor , Edwards oximetry central venous catheter and
PediaSat oximetry catheters and VolumeView set.
through more informed volume administration.
solution to help my
hospital extend advanced
to more patients.
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for some common sense. Crit Care Med 2013
2. Le Manach et al. Can changes in arterial pressure be used to detect changes in cardiac output during volume
expansion in the perioperative period? Anesthesiology 2013
3. Bellamy MC. Wet, dry or something else? Br J Anaesth 2006;97(6):755-757
4. Grocott et al. Perioperative increase in global blood flow to explicit defined goals and outcomes after surgery: a
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