Perioperative hemodynamic optimization: a revised approach

•18% of patients undergoing surgery will develop a major postoperative complication•Postoperative complications increase the risk of long term mortality•Perioperative hemodynamic optimization reduces the risk of complications•An oxygen debt is incurred in the immediate postoperative period•Hemodynamic optimization should continue for up to 12 hours following surgery

Contemporary data suggest that approximately 18% of patients undergoing surgery will develop a major postoperative complication, and 3% to 5% will die prior to hospital discharge. Patients who develop a postoperative complication are at an increased risk of long-term mortality. Multiple studies have shown that perioperative hemodynamic optimization reduces the risk of postoperative complications and death in elective noncardiac surgical patients.