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Minimally invasive monitoring in patients under general anesthesia

PhD ceremony:Mr J.J. (Jaap Jan) Vos
When:March 02, 2015
Start:16:15
Supervisors:prof. dr. T.W.L. (Thomas) Scheeren, prof. dr. M.M.R.F. (Michel) Struys
Co-supervisor:A.F. Kalmar
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Minimally invasive monitoring in patients under general anesthesia

In this thesis we investigated the reliability of methods to monitor the cardiovascular system and liver function in patients under anesthesia. As the anesthesiologist aims to guarantee a sufficient amount of oxygen in various tissues for the prevention of postoperative complications, the optimal monitoring is as harmless as possible. Traditionally, monitoring was sometimes accomplished with complex techniques – requiring invasive catheters – with associated risks for the patient. Newer techniques allow measurements without posing risks to the patient. In this thesis we demonstrated, for example, that transcutaneous methods can predict whether a patient requires additional fluid in order to guarantee oxygen delivery. Also, a ‘finger clip’ method, which allows measuring blood pressure continuously, was shown to be not inferior compared to the current clinical standard for measuring blood pressure, cuff manometry. Yet another method that measures hemoglobin concentration transcutaneously was shown to be influenced by certain factors.

Furthermore this thesis provides a review on the current literature regarding the adequacy of determining liver function transcutaneously with a dye. We found that adequate postoperative graft function can be predicted at the end of a liver transplantation procedure.

The methods we studied to monitor hemodynamics and liver function, which pose minimal extra risks to patients, potentially allow individualised therapy to improve patient outcome.