Last month saw World Anaesthesia Day and now this month we’re also celebrating the 25th anniversary of the Royal College of Anaesthetists, which received its Royal Charter as recently as 1992. TheBritish Journal of Anaesthesia has marked the events by selecting 25 papers it considers to have been its most influential. It published the earliest in 1954!
In recognition of the undoubted impact of oesophageal Doppler monitoring in recent years, of the 25 papers cited, two relate to the technology. The earlier (2002) paper* (Venn et al) compares conventional intraoperative fluid management with two methods of invasive monitoring (central venous pressure and oesophageal Doppler) and concludes that; “Invasive intraoperative haemodynamic monitoring with fluid challenges during repair of femoral fracture under general anaesthetic shortens time to being medically fit for discharge.”
The later (2005) paper** investigated the phenomenon of occult hypovolaemia during surgery. The authors discuss the idea that this common and often unrecognised state could lead to intraoperative gut hypoperfusion. This is associated with increased morbidity and longer postoperative hospital stay.
Deltex Medical Group’s Managing Director, Andy Mears commented; “Despite the intervening years, these two papers still underpin everything we recognise in the power of intraoperative fluid management to deliver better patient outcomes. The fact that the BJA recognises them as two of their most important studies in the last 63 years is testament to the impact oesophageal Doppler monitoring has had. It remains the most accurate, real-time method of assessing haemodynamic status, direct from the aorta.”
