Interpretation of the statement from the European Society of Anaesthesiology and Intensive Care： Intra-operative hemodynamic monitoring and management of adults having noncardiac surgery
Received date: 2025-07-14
Online published: 2025-11-13
术中血流动力学监测与管理是成人非心脏手术围术期管理的核心环节，对保障组织灌注、预防器官损伤具有重要意义。2025年6月，欧洲麻醉与重症医学会发布《成人非心脏手术的术中血流动力学监测和管理声明》，该声明由25位国际多学科专家基于循证医学证据制定，涵盖动脉血压管理、心率调控、每搏输出量与心输出量监测、心脏前负荷评估及液体反应性判断、微循环监测、麻醉深度与脑氧饱和度监测等六大方面。本文对声明要点进行解读，包括监测方法的选择与局限性、各项指标的管理策略（如推荐以平均动脉压≥ 60 mmHg为管理基准，不建议将动脉压作为心输出量的替代指标等），旨在为国内麻醉医师提供临床参考，优化成人非心脏手术患者的术中血流动力学管理。
徐婉卓 , 薄禄龙 . 欧洲麻醉与重症医学会《成人非心脏手术的术中血流动力学监测和管理声明》的解读[J]. 实用医学杂志, 2025 , 41(21) : 3305 -3310 . DOI: 10.3969/j.issn.1006-5725.2025.21.001
Intraoperative hemodynamic monitoring and management are essential components of perioperative care for adult patients undergoing non?cardiac surgery， as they are critical for maintaining adequate tissue perfusion and preventing organ dysfunction. In June 2025， the European Society of Anaesthesiology and Intensive Care （ESAIC） published the “Statement on Intraoperative Hemodynamic Monitoring and Management in Adult Non? Cardiac Surgery.” Developed by a panel of 25 international multidisciplinary experts using an evidence?based approach， this statement addresses six key domains： arterial blood pressure management， heart rate regulation， stroke volume and cardiac output monitoring， assessment of cardiac preload and fluid responsiveness， application of microcirculation monitoring techniques， and integrated management of anesthesia depth with cerebral oxygen saturation monitoring. This article provides a comprehensive interpretation of the statement′s core recommendations， including guidance on the selection and limitations of monitoring modalities， as well as specific management targets for instance， recommending a mean arterial pressure of at least 60 mmHg as a threshold for intervention and explicitly advising against the use of arterial pressure as a surrogate for cardiac output. The objective is to offer practical clinical guidance for anesthesiologists and to enhance the precision and effectiveness of intraoperative hemodynamic management in adult non?cardiac surgical patients.
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