1. Improving Fluid and Blood Management by Continuous Noninvasive Monitoring

2. This program will include a discussion of agents not approved by the FDA for use in the US

3. GDT in the Surgical Setting

4. Oxygen Delivery

5. Perioperative GDT: Rationale

6. The Classic Approach to GDT Maximize SV With Fluid Boluses

7. The Supra-Normal Values Approach

8. GDT: Claims and Challenges

9. OPTIMISE: Design and Results

10. GDT: Terminology, Benefits, and Ongoing Challenges

11. Maximizing SV Often Results in Excess Fluid Administration

12. POM-O

13. Fluid Management Requires a Careful Balancing Act

14. Prevalent Iatrogenic "Dark Sides" of Fluid Administration

15. Fluid Responsiveness

16. Static Measures of Fluid Response

17. Determining Who Will Be Responders

18. Methods Currently Available to Detect, or Unmask, a Fluid Responsive State

19. Determining Responders and Nonresponders: Mechanical Breath

20. Determining Responders and Nonresponders: Mechanical Breath (cont)

21. SPV, PPV, SVV

22. Monitors That Noninvasively Measure Dynamic Parameters

23. Possible Choice of Monitoring System in Relation to a Patient's Degree of Perioperative Risk

24. PVI and ΔPOP

25. PVI

26. Dynamic Parameters Assist in Identifying Nonresponders

27. Advantages of Using Dynamic Parameters in GDT

28. Dynamic Parameters to Guide GDT

29. Limitations and Confounding Factors of Dynamic Parameters

30. Real-Time Visibility of Changes in Hb Concentration With SpHb

31. Potential Benefits of SpHb Monitoring

32. Bleeding Is a Common Complication During Emergency General Surgery

33. Hb Recommendations From the European Guidelines on the Management of Major Bleeding and Coagulopathy Following Trauma

34. SpHb Monitoring in a Patient After Multiple Trauma

35. SpHb Monitoring in a Patient After Multiple Trauma (cont)

36. Continuous SpHb Measurement During Exploratory Laparotomy

37. Practice Guidelines

38. Complications Associated With Blood Transfusion

39. SpHb Measurements Over 4 Days in an 84-Year-Old Patient With Pneumonia in the ICU

40. Hb and Altitude: The Lower You Fly, the Lower Your Tolerance for Error

41. Transfusion Practices: Personalized and Precise

42. Iatrogenic Hemodilution May Affect the Hb Concentration

43. Ḋo2 Decreased in Volume Nonresponders Due to Hemodilution

44. POM-O Revisited

45. Patients Who Receive More Fluids as Part of GDT May Also Receive More Blood Transfusions

46. Continuous Monitoring of SpHb May Reveal the Development of Iatrogenic Hemodilution in Real Time

47. Continuous Trends of Noninvasive SpHb and PVI Denoting the Development of Iatrogenic Hemodilution

48. Is the Decrease in SpHb Due to Active Bleeding or Developing Hemodilution?

49. Conclusions

50. Abbreviations

51. Abbreviations (cont)

52. Abbreviations (cont)

53. Abbreviations (cont)