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Article . 2025
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European Journal of Anaesthesiology
Article . 2025 . Peer-reviewed
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Intra-operative haemodynamic monitoring and management of adults having noncardiac surgery

A statement from the European Society of Anaesthesiology and Intensive Care
Authors: Saugel, B.; Buhre, W.; Chew, M. S.; Cholley, B.; Coburn, M.; Cohen, B.; de Hert, S.; +17 Authors

Intra-operative haemodynamic monitoring and management of adults having noncardiac surgery

Abstract

This article was developed by a diverse group of 25 international experts from the European Society of Anaesthesiology and Intensive Care (ESAIC), who formulated recommendations on intra-operative haemodynamic monitoring and management of adults having noncardiac surgery based on a review of the current evidence. We recommend basing intra-operative arterial pressure management on mean arterial pressure and keeping intra-operative mean arterial pressure above 60 mmHg. We further recommend identifying the underlying causes of intra-operative hypotension and addressing them appropriately. We suggest pragmatically treating bradycardia or tachycardia when it leads to profound hypotension or likely results in reduced cardiac output, oxygen delivery or organ perfusion. We suggest monitoring stroke volume or cardiac output in patients with high baseline risk for complications or in patients having high-risk surgery to assess the haemodynamic status and the haemodynamic response to therapeutic interventions. However, we recommend not routinely maximising stroke volume or cardiac output in patients having noncardiac surgery. Instead, we suggest defining stroke volume and cardiac output targets individually for each patient considering the clinical situation and clinical and metabolic signs of tissue perfusion and oxygenation. We recommend not giving fluids simply because a patient is fluid responsive but only if there are clinical or metabolic signs of hypovolaemia or tissue hypoperfusion. We suggest monitoring and optimising the depth of anaesthesia to titrate doses of anaesthetic drugs and reduce their side effects.

Keywords

*Surgical Procedures, Adult, Cardiac Output/physiology, Operative/methods/standards/adverse effects, Critical Care, *Anesthesiology/standards/methods, Hemodynamic Monitoring, *Hemodynamic Monitoring/methods/standards, Hemodynamics, Hemodynamics/physiology, [SDV] Life Sciences [q-bio], Europe, Review Literature as Topic, Anesthesiology, Monitoring, Intraoperative, Surgical Procedures, Operative, Medical/standards, Humans, Intraoperative/methods/standards, *Monitoring, Cardiac Output, Societies, *Critical Care/methods/standards, Societies, Medical

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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Average
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