Riassunto
Il principio sul quale si basa il convincimento che la GDHT (Goal Directed Hemodynamic Therapy) è importante nel diminuire la mortalità, le complicanze e la LOS (lenght of stay, durata della degenza) dei pazienti a rischio sottoposti a chirurgia (essenzialmente chirurgia addominale, toracica, vascolare, nel politrauma, nei settici e, in genere, chirurgia dove sono prevedibili larghe perdite ematiche) è quello che lo stress chirurgico può essere favorevolmente affrontato solo con una disponibilità di O2 indicizzata (DO2I) adeguata alle esigenze metaboliche (CaO2 · CI · 10 = ⩾ 600 ml/m2/min). In caso contrario l’ossigenazione tessutale può essere insoddisfacente soprattutto in alcuni distretti (in primis quello intestinale) con l’insorgenza di complicanze (per esempio, ileo paralitico di lunga durata) a loro volta causa di altre (per esempio, tachicardia, ipotensione, ischemie miocardiche) che, come minimo, allungano la LOS, ma che possono anche aumentare la mortalità.
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Allaria, B. (2011). Ha ancora un senso la GDHT nel perioperatorio del paziente a rischio?. In: Allaria, B. (eds) Excerpta Anestesiologica. Springer, Milano. https://doi.org/10.1007/978-88-470-2023-8_2
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DOI: https://doi.org/10.1007/978-88-470-2023-8_2
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