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CME: Hemodynamic optimization


Program Description / Statement of Need:

In this online CME self-learning program:

The role of hemodynamic monitoring has direct implications, both in the near- and long-term, in predicting patient outcomes after surgery.  The trending of stroke volume and its subsequent guidance of fluid administration can improve a patient’s oxygen delivery index which, in turn, determines the patient’s risk of post-operative complications in a variety of surgeries. The employment of hemodynamic monitoring and goal-directed therapy in a protocolized fashion improves post-operative complications within a given window of opportunity; this program examines the components of successful monitoring techniques and discusses how they may be applied to the overall surgical patient population.


While flow-based hemodynamic monitoring and interventions has been shown to improve morbidity and sometime mortality outcomes to date in surgical patients, practitioners have been reluctant to adopt the practice in a widespread fashion, perhaps in part because the individual studies involve contained small sample sizes.  The question also remains: does the same relationship between monitoring and outcomes hold since the advent of less invasive strategies and improved quality of care?  At least one meta-analysis of recent studies indicates that it does, which suggests that a failure to employ these monitoring techniques in post-surgical patients may be associated with a gap in care.



  • -      Beginning with the basics: a definition of hemodynamic monitoring
  • -     The role of strategy in mind when engaging in hemodynamic monitoring
  • -      The potential adverse outcomes of major surgery and how hemodynamic monitoring might prevent them
  • -      Summary of the evidence


Target Audience:

This program has been designed for a multidisciplinary physician and nurse audience including: ICU / Anesthesia / Peri-op / Intensivists / Trauma / Critical Care

Program Objectives:

By the end of the session the participant will be able to:

    • Describe the components of hemodynamic monitoring that determine oxygen delivery index.
    • Describe the treatment approaches that optimize post-operative hemodynamics.
    • Discuss the association between post-operative complications and long-term mortality.
    • Discuss the association, if any, that early, goal-directed therapy has with post-operative patient outcomes.
    • Apply literature-demonstrated hemodynamic optimization techniques and thresholds to a given patient case


    This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.


    Credit Designation: ScientiaCME designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

    Release Date: February 24, 2012
    Expiration Date: February 24, 2014

    Faculty: Maurizio Cecconi MD, MD (UK)

    Faculty Disclosure and Resolution of COI:

    As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved through content review ScientiaCME.


    Faculty Disclosure: Maurizio Cecconi, MD, MD(UK) discloses that he receives honoraria and expense reimbursement from Edwards Lifesciences, LiDCO, Cheetah Medical, Masimo, and Nexfin Bmeye.


    Disclosures of Educational Planners: Steven Sachse is an officer and part owner of ScientiaCME, LLC, which has received a grant from the commercial supporter of this program: Edwards Lifesciences.


    Commercial Support Disclosure: This program is supported by an educational grant from Edwards Lifesciences, a manufacturer of medical devices.


    Viewing Requirements:



    Windows 2000 or above
    Internet Explorer 5.5
    Adobe Acrobat Reader*

    Mac OS 10.2.8
    Adobe Acrobat Reader*
    Internet Explorer is not supported on the Macintosh


    *Required to view Printable PDF Version


    Privacy Policy



    -Read the learning objectives and faculty disclosures above

    -Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.

    -View the on-line program. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.

    -Take the post-test

    -Complete the program evaluation and CME registration. A CE certificate will be emailed to you.

    Perform Pre-Test (optional)
    Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

    Download the Presentation (optional)


    View the online program


    Perform Post-Test

    Complete the Symposium Evaluation and Request CE Certificate

This program is supported by Educational Grants from Edwards Lifesciences


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