Targeted Volume Management The right amount of the right fluid at the right time The CardioQ-ODM™ in Surgery A unique solution The CardioQ-ODM™ in Surgery A unique solution
Problem Perioperative Fluid Management A fundamental influence on surgical outcome Why? - Nil by mouth - Anaesthetic - Surgery Hypovolaemia the primary cause of non-surgical post-operative complications
Solution Targeted Volume Management The right amount of the right fluid at the right time Why? - Fuller recovery - Faster recovery - Home earlier
Tool CardioQ-ODM Volume management tailored to individual patient need Why? - It’s easy - It’s safe - It works
Technology Intervene - Early - Quickly - Safely
Evidence Level 1 grade A evidence demonstrates that TVM using ODM Improves the quality of recovery Reduces complications Reduces length of hospital stay Reduces critical care demand Good for all, crucial for some
RCTs in Major Surgery Reduction in complications
RCTs in Major Surgery Reduction in Length of Stay 0
Unique Evidence Base The only intra-operative haemodynamic monitor Proven in multiple RCTs to reduce complications and shorten lengths of hospital stay Subject to 3 independent meta-analyses Subject to 2 independent Health Technology Assessments
Why does it work?
The right amount of the right fluid at the right time
The Aims of TVM To achieve optimal filling of the vascular system Eliminate hypovolaemia Optimise oxygen delivery To avoid excess crystalloid use Avoid tissue oedema Avoid adverse impact of chloride on gut
Key Components of TVM Delivery of appropriate crystalloid volumes for ‘maintenance’ Oesophageal Doppler-guided stroke volume optimisation using colloids to eliminate hypovolaemia - Better outcomes - Faster, fuller recovery - Earlier home
Is it worth it? Surgical teams that do this Have lower mortality rates Have lower readmission rates Have shorter lengths of stay
TVM in Evidence-based Protocols
Targeted Volume Management Reduced complications Reduced Length of Stay The right amount of the right fluid at the right time