Toward Precision Hemodynamic Management*

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We live now in the era of personalized or precision medicine. The goal of precision medicine is to customize and titrate therapy according to individual needs. Regarding hemodynamic management, there are multiple clinical situations where therapeutic interventions are still based on one-size-fits-all approaches. These situations include, but are not limited to, fluid loading before anesthesia induction, restrictive or liberal fluid regimen during surgery, empirical fluid or vasopressor administration in patients becoming hypotensive, and pacing rate setting after cardiac surgery. These practices were acceptable when hemodynamic evaluations were time consuming and required invasive vascular access and/or specific skills. They are more questionable now that measuring blood pressure, blood flow, and their determinants is possible with easy-to-use, nonoperator-dependent, and noninvasive methods (1).
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