1. 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

2. 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

3. Solution Targeted Volume Management The right amount of the right fluid at the right time Why? - Fuller recovery - Faster recovery - Home earlier

4. Tool CardioQ-ODM Volume management tailored to individual patient need Why? - It’s easy - It’s safe - It works

5. Technology Intervene - Early - Quickly - Safely

6. 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

7. RCTs in Major Surgery Reduction in complications

8. RCTs in Major Surgery Reduction in Length of Stay 0

9. 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

10. Why does it work?

11. The right amount of the right fluid at the right time

12. 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

13. 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

14. Is it worth it? Surgical teams that do this Have lower mortality rates Have lower readmission rates Have shorter lengths of stay

15. TVM in Evidence-based Protocols

16. Targeted Volume Management Reduced complications Reduced Length of Stay The right amount of the right fluid at the right time