Perioperatives hämodynamisches Monitoring – ein Überlebensvorteil für anästhesiologisch betreute Patienten?

Zusammenfassung

Das perioperative hämodynamische Monitoring kann in ein obligates, nicht invasives Basismonitoring und ein erweitertes hämodynamisches Monitoring unterteilt werden. Sowohl patienten–, als auch operationsspezifische Aspekte können die Indikation für eine Erweiterung des hämodynamischen Monitorings darstellen. Nutzen und Qualität der perioperativen Patientenüberwachung hängen ausschließlich von der Kenntnis der Möglichkeiten und Limitationen der eingesetzten Monitoringinstrumente ab.

Abstract

Both, obligatory non–invasive hemodynamic monitoring and adjunctive hemodynamic monitoring need to be considered perioperatively. Patient as well as surgical requirements may contribute to the decision making process. Effectiveness and quality of the perioperative patient monitoring solely depends on the knowledge and awareness of the anesthesist with regard to the potentials and limitations of the applied monitoring.

Monitoring; Anästhesie - Herz–Kreislauf–System; Hämodynamik

monitoring; anesthesia - cardio–vascular system; hemodynamic

Kernaussagen

• Die häufigsten Ursachen perioperativer Morbidität und Letalität stellen kardiovaskuläre Erkrankungen dar.

• Das Ziel des hämodynamischen Monitorings ist die Sicherstellung einer adäquatenOrganperfusion mit entsprechender Organoxygenierung und –nutrition.

• Das erweiterte hämodynamische Monitoring allein verbessert die Patientenprognose nicht, ist aber mit einer Zunahme von Risiken und Komplikationen assoziiert.

• Möglichkeiten, Grenzen, Risiken und das spezifische Fehlerpotential der eingesetzten Messinstrumente sollten dem Anwender bekannt sein.

• Allein die Kenntnis des Anästhesisten entscheidet, ob ein Überwachungsverfahren nützlich oder schädlich ist.

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