• Mervyn Singer.
• Department of Medicine, University College London, London, UK. msinger@ucl.ac.uk
• Curr Opin Anaesthesiol. 2011 Apr 1;24(2):171-6.

Purpose Of ReviewTo determine whether sufficient evidence exists to justify routine use of oesophageal Doppler monitoring to guide perioperative haemodynamic management in high-risk surgery.Recent FindingsSystematic reviews of the literature have been performed independently by the National Health Service Centre for Evidence-based Purchasing in the UK, and the US Agency for Healthcare-Related Quality. A before-after evaluation was also recently performed in three hospitals by the National Health Service Technology Adoption Centre. Although multicentre prospective randomized controlled trials are lacking, the evidence base for both outcome-benefit and cost-benefit is considered strong enough by the National Institute for Health and Clinical Excellence in the UK for them to recommend use of this technology in high-risk surgical patients. Whether these findings also apply to other monitoring technologies requires formal validation.SummaryBetter patient outcomes can be achieved by perioperative haemodynamic optimization using oesophageal Doppler monitoring and should be considered for routine use in most types of high-risk surgery.

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