Pre-operatieve hemodynamische optimalisatie door middel van het verhogen van het zuurstof-aanbod bij hoog-risico-chirurgie

Preoperative hemodynamic optimization by means of augmenting oxygen delivery is an attractive concept to reduce morbidity after major surgery. Several prospective controlled randomised studies demonstrate a positive effect on mortality and morbidity. However, it is still uncertain which patients will benefit most from such a policy and by what means preoperative optimization is best achieved. We believe that the target of optimization should not be a prefixed value for oxygen delivery, but rather one individualized for each patient ("tune-up"). In this regard, a better preoperative fluid-status appears to be most essential.