Decision support for hemodynamic management: from graphical displays to closed loop systems

Anesth Analg. 2013 Oct;117(4):876-882. doi: 10.1213/ANE.0b013e31827e5002. Epub 2013 Feb 28.


The way hemodynamic therapies are delivered today in anesthesia and critical care is suboptimal. Hemodynamic variables are not always understood correctly and used properly. The adoption of hemodynamic goal-directed strategies, known to be clinically useful, is poor. Ensuring therapies are delivered effectively is the goal of decision support tools and closed loop systems. Graphical displays (metaphor screens) may help clinicians to better capture and integrate the multivariable hemodynamic information. This may result in faster and more accurate diagnosis and therapeutic decisions. Graphical displays (target screens) have the potential to increase adherence to goal-directed strategies and ultimately improve patients' outcomes, but this remains to be confirmed by prospective studies. Closed loop systems are the ultimate solution to ensure therapies are delivered. However, most therapeutic decisions cannot be based on a limited number of output variables. Therefore, one should focus on the development of systems designed to relieve clinicians from very simple and repetitive tasks. Whether intraoperative goal-directed fluid therapy may be one of these tasks remains to be evaluated.

Publication types

  • Review

MeSH terms

  • Anesthesia / methods*
  • Anesthesia / trends*
  • Animals
  • Computer Graphics / instrumentation
  • Computer Graphics / trends*
  • Decision Support Systems, Clinical / instrumentation
  • Decision Support Systems, Clinical / trends*
  • Hemodynamics / physiology*
  • Humans