Abstract Significant evidence outlines that the management
of the high-risk surgical patient with perioperative
hemodynamic optimization leads to significant benefits.
This study aimed at studying the current practice of
hemodynamic monitoring and management of Italian
anesthesiologists. An invitation to participate in a webbased
survey was published on the web site of the Societa`
Italiana di Anestesia Analgesia Rianimazione Terapia Intensiva.
Overall, 478 questionnaires were completed. The
most frequently used monitoring techniques was invasive
blood pressure (94.1 %). Cardiac output was used in 41.3 %
of the cases mainly throughout less-invasive methods.
When cardiac output was not monitored, the main reason
given was that other surrogate techniques, mainly central
venous oxygen saturation (40.5 %). Written protocols
concerning hemodynamic management in high-risk surgical
patients were used by the 29.1 % of the respondents. 6.3 %
of the respondents reported not to be aware if such document
was available at their institution. 86.3 % of the
respondents reported that they usually optimize high risk
patients but to use blood flow assessment rarely (39.7 %).
The most used parameter in clinical practice to assess the
effects of volume loading were an increase in urine output
and arterial blood pressure together with a decrease in heart
rate and blood lactates. The 45.1 % or the respondents
outlined that hemodynamic optimization in the high risk
patients is of major clinical value. Our study outlines an
important gap between available evidence and clinical
practice emphasizing the need for a better awareness, more
information and knowledge on the specific topic.
