{"id":750,"date":"2017-02-14T14:08:05","date_gmt":"2017-02-14T14:08:05","guid":{"rendered":"http:\/\/www.deltexmedical.com\/decision_tree\/?page_id=750"},"modified":"2025-10-10T12:37:31","modified_gmt":"2025-10-10T11:37:31","slug":"home","status":"publish","type":"page","link":"https:\/\/www.deltex-academy.com\/decision_tree\/","title":{"rendered":"Home"},"content":{"rendered":"<style>.entry-title {display:none;}<br \/><\/style>\n<style>.site-info {display: none;}<br \/><\/style>\n<h2 style=\"text-align: center;\"><strong><span style=\"color: #003087;\">INTRODUCTION\u00a0<\/span><\/strong><\/h2>\n<p>Oesophageal Doppler monitoring is a precise, minimally invasive method of measuring CO. Oesophageal Doppler monitoring was initially developed as a less invasive alternative to the pulmonary artery catheter, however, its ability to drive the flow-based treatment algorithms was soon recognised.<\/p>\n\t\t<div class=\"wpsisac-slick-slider-wrp wpsisac-clearfix \" data-conf=\"{&quot;dots&quot;:&quot;true&quot;,&quot;arrows&quot;:&quot;true&quot;,&quot;autoplay&quot;:&quot;true&quot;,&quot;autoplay_interval&quot;:&quot;5000&quot;,&quot;fade&quot;:&quot;false&quot;,&quot;lazyload&quot;:&quot;&quot;,&quot;speed&quot;:&quot;1000&quot;,&quot;rtl&quot;:&quot;false&quot;,&quot;loop&quot;:&quot;true&quot;,&quot;hover_pause&quot;:&quot;true&quot;}\">\r\n\t\t\t<div id=\"wpsisac-slick-slider-1\" class=\"wpsisac-slick-init wpsisac-slick-slider design-1 \">\r\n\r\n\t\t\t\t<div class=\"wpsisac-image-slide\">\r\t<div class=\"wpsisac-slide-wrap\" style=\"\">\r\t\t\t\t\t<img decoding=\"async\"  src=\"https:\/\/www.deltex-academy.com\/decision_tree\/wp-content\/uploads\/2017\/01\/intro-1-e1484644207998.jpg\" alt=\"left ventricular filling\" \/>\r\t\t\t<\/div>\r<\/div><div class=\"wpsisac-image-slide\">\r\t<div class=\"wpsisac-slide-wrap\" style=\"\">\r\t\t\t\t\t<img decoding=\"async\"  src=\"https:\/\/www.deltex-academy.com\/decision_tree\/wp-content\/uploads\/2017\/01\/malcom-430-1.png\" alt=\"malcolm probe\" \/>\r\t\t\t<\/div>\r<\/div><div class=\"wpsisac-image-slide\">\r\t<div class=\"wpsisac-slide-wrap\" style=\"\">\r\t\t\t\t\t<img decoding=\"async\"  src=\"https:\/\/www.deltex-academy.com\/decision_tree\/wp-content\/uploads\/2024\/11\/2-monitors.jpg\" alt=\"monitor\" \/>\r\t\t\t<\/div>\r<\/div>\r\n\t\t\t<\/div>\r\n\t\t<\/div>\r\n\t\n<p>It is accepted that both <a href=\"https:\/\/www.deltex-academy.com\/decision_tree\/circulating-blood-volume\/\">excessive and inadequate fluid volumes<\/a> are detrimental to patient outcome. Doppler-guided intraoperative fluid management (IOFM) is an important component of <a href=\"https:\/\/www.deltex-academy.com\/decision_tree\/enhanced-recovery-and-fast-track-surgery\/\">Enhanced Recovery (ERAS)<\/a> programmes, and has been proven to <a href=\"http:\/\/www.deltexmedical.com\/decision_tree\/improved-outcomes\/\">improve outcome<\/a> in a variety of patient groups. This decision tree is a consolidation of the evidence base surrounding Doppler-guided <a href=\"https:\/\/www.deltex-academy.com\/decision_tree\/stoke-volume-optimisation\/\">SV optimisation<\/a>, and the use of vasoactive and inotropic interventions as part of a global haemodynamic protocol.<\/p>\n<p>An expert panel of senior clinicians reviewed the available evidence and agreed on a rational approach to using Doppler flow based measurements to guide therapy. This decision tree is appropriate for patients both perioperatively and in critical care. It is applicable for those patients already being monitored with Oesophageal Doppler monitoring, or for those where further haemodynamic monitoring is indicated as per <a href=\"https:\/\/www.deltex-academy.com\/decision_tree\/trigger-points-and-concerns\/\">trigger points<\/a>.<\/p>\n<p>The decision tree is evidence based, or it can be used as a foundation for the development of other protocols.<\/p>\n<h3><span style=\"color: #003087;\">Using the Decision Tree<\/span><\/h3>\n<p>To view the decision tree <a href=\"https:\/\/www.deltex-academy.com\/decision_tree\/decision_tree\/\">click here<\/a><\/p>\n<p>Navigation is by a series of Yes\/No boxes. Actions are in blue boxes and questions in grey boxes.<\/p>\n<p>Please note that caveats are presented which may lead to an alternative pathway, or can be ignored if not appropriate for the patient. Caveats are in red boxes with red pathways.<\/p>\n<p>Where possible there are links to the evidence base. Linked items are underlined in yellow and are in the form of hyperlinks, which will open a new window with an explanation and references.<\/p>\n<p>See the <a href=\"https:\/\/www.deltex-academy.com\/decision_tree\/glossary\/\">Glossary<\/a> for a list of abbreviations and definitions.<\/p>\n<p>An App for iPhone and Android is available, please search for &#8220;Deltex Guide&#8221; in either Apples app store or Google play store.<\/p>\n<p>For further information please <a href=\"http:\/\/www.deltexmedical.com\/decision_tree\/contact\/\">contact<\/a> us.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>INTRODUCTION\u00a0 Oesophageal Doppler monitoring is a precise, minimally invasive method of measuring CO. Oesophageal Doppler monitoring was initially developed as a less invasive alternative to the pulmonary artery catheter, however, its ability to drive the flow-based treatment algorithms was soon recognised. It is accepted that both excessive and inadequate fluid volumes are detrimental to patient &hellip; <a href=\"https:\/\/www.deltex-academy.com\/decision_tree\/?post_type=slick_slider&#038;p=427\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;monitor&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-750","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/pages\/750","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/comments?post=750"}],"version-history":[{"count":5,"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/pages\/750\/revisions"}],"predecessor-version":[{"id":1299,"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/pages\/750\/revisions\/1299"}],"wp:attachment":[{"href":"https:\/\/www.deltex-academy.com\/decision_tree\/wp-json\/wp\/v2\/media?parent=750"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}