Goal Directed Therapy in Cardiac Surgery

Every year 320 million surgeries done that 16.8% develop one or more complications and 2.8% die of their complication (1.5 million /year)There is some evidence that preoperative GDT can decrease complications after cardiac surgery. Patients with complications use a greater amount of resources and therefore these patients are associated with higher health care cost In the immediate post cardiopulmonary bypass period, the recognition and treatment of the cause may be beneficial in terms of outcome The standard parameters do not give enough information in unstable patientsWe should be able to monitor:• 1.CO• 2.Preload volume Responsiveness• 3.SVRGDT is the use of hemodynamic parameters, beyond standard ones (e.g. HR, BP) to optimize O2 DeliverConclusion:• Postoperative morbidity is still significant• The standard parameters do not give enough information in unstable patients• We should be able to monitor :CO/ Preload volume Responsiveness / SVR• GDT describes the early alteration of hemodynamic parameters to guide the intravenous fluid and inotropic therapy to achieve preset goals• Perioperative GDT can decrease some complications after cardiac surgery.