French Guidelines (SFAR) make ODM standard of Care in France
Today, the Société Française d’Anesthésie et de Réanimation (SFAR) guidelines were published in France and make it clear that ODM-guided fluid management should be used in all high risk surgery in France. This is estimated to cover 750,000 patients a year, of which only currently one percent are treated using the ODM despite it being a market leader of IOFM in France. In France clinical guidelines such as these are the key driver behind wide scale changes in clinical practice and, therefore, accelerated adoption of medical technologies. Gamida, the French distributor for Deltex Medical has expanded its clinical training team this year and established an additional hospital training centre.
The key recommendations in respect of Intra-Operative Fluid Management (‘IOFM’) monitoring are:
- Titration of fluids guided by measuring stroke volume (’SV’) in order to reduce post
- Operative morbidity and length of hospital stay
- Stop filling if SV does not increase
- Reassess SV regularly and its response to a fluid challenge especially during periods of haemodynamic instability
All of these recommendations are graded in the highest category ‘1+’, meaning that SFAR members are expected to comply because the evidence level is high, and that future evidence is unlikely to change the conclusions from the current evidence. In France clinical guidelines from professional societies determine the standards expected of their members based on clinical benefit.
The recommendations are based on the oesophageal Doppler monitoring (“ODM”) evidence and the guidelines make it clear that this evidence should not be assumed to apply to alternative technologies.