[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-444899-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-444899-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","continuous-hemodynamic-monitoring-and-goal-directed-therapy-for-optimization-in-total-knee-replacement-a-prospective-observational-study","Continuous Hemodynamic Monitoring and Goal-Directed Therapy for Optimization in Total Knee Replacement - A Prospective Observational Study","","Goal-directed fluid therapy (GDT) optimizes perioperative hemodynamics by matching fluid administration to individual patient needs. This prospective observational study assessed GDT guided by the non-invasive ClearSight monitoring system in patients undergoing total knee arthroplasty under spinal anesthesia. Forty participants were managed using either a GDT protocol or standard fluid therapy. The GDT group received less intraoperative crystalloid, showed shorter post-anesthesia care unit stay, and maintained more stable mean arterial pressure. Results support continuous non-invasive monitoring to improve intraoperative fluid optimization and early recovery, while larger randomized trials are needed.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/continuous-hemodynamic-monitoring-and-goal-directed-therapy-for-optimization-in-total-knee-replacement-a-prospective-observational-study/444899/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/continuous-hemodynamic-monitoring-and-goal-directed-therapy-for-optimization-in-total-knee-replacement-a-prospective-observational-study/444899.png","ImageObject",300,407,{"name":42,"@type":43},"SANS","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-01","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the main goal of goal-directed fluid therapy (GDT) in this study?","Question",{"text":63,"@type":64},"To optimize perioperative hemodynamics by tailoring fluid administration to each patient’s individual needs using real-time monitoring.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which monitoring system guided GDT for patients undergoing total knee arthroplasty?",{"text":68,"@type":64},"The non-invasive ClearSight monitoring system (Edwards Lifesciences Corporation).",{"name":70,"@type":61,"acceptedAnswer":71},"What outcomes differed between the GDT group and standard fluid therapy?",{"text":72,"@type":64},"The GDT group received less intraoperative crystalloid, stayed for a shorter period in the post-anesthesia care unit, and maintained more stable mean arterial pressure during the procedure.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},444899,1790742235,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":124,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},962090760505,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Review began 10/07/2025  \nReview ended 11/28/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nChristofis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98605  \nOpen Access Original Article  \nContinuous Hemodynamic Monitoring and GoalDirected Therapy for Optimization in Total Knee Replacement: A Prospective Observational Study  \nChristos Christofis 1, Martha Kyriakou 2 , Alexandra Arvanitaki 3, Kostas Kazakos 6, Theodosia Vogiatzaki 7, Chloropoulou Pelagia  \n4 , Konstantinos Tilkeridis 5 , 7  \n1. Department of Anesthesiology, University General Hospital of Alexandroupolis, Democritus University of Thrace, Nicosia, CYP 2. Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, CYP 3. Department of Adult Congenital Heart Disease, Royal Brompton Hospital, London, GBR 4. 2nd Cardiology Department, Aristotle University of Thessaloniki, Thessaloniki, GRC 5. Department of Orthopaedic Surgery, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, GRC 6. Department of Medicine, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, GRC 7. Department of Anesthesiology, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, GRC  \nCorresponding author: Christos Christofis, [christofischristos@hotmail.com](christofischristos@hotmail.com)  \nAbstract  \nGoal-directed fluid therapy (GDT) has become an important strategy for optimizing perioperative hemodynamics by tailoring fluid administration to each patient’s individual needs. In this prospective observational study, we evaluated the use of GDT guided by the non-invasive ClearSight monitoring system (Edwards Lifesciences Corporation, Irvine, CA, USA) in patients undergoing total knee arthroplasty (TKA) under spinal anesthesia. Forty patients were included and managed either with a GDT protocol or with standard fluid therapy. Hemodynamic parameters, fluid administration, and early postoperative outcomes were assessed. Patients in the GDT group received significantly less intraoperative crystalloid volume compared to controls and had a shorter stay in the post-anesthesia care unit. Moreover, the GDT group demonstrated more stable mean arterial pressure throughout the procedure. These findings suggest that continuous non-invasive hemodynamic monitoring can enhance intraoperative fluid optimization and improve immediate recovery following orthopedic surgery. Larger randomized trials are necessary to confirm these results and further define the clinical benefits of GDT in this setting.  \nCategories: Orthopedics  \nKeywords: clearsight system, goal-directed fluid therapy, hemodynamic monitoring, intraoperative fluid management, non-invasive monitoring, perioperative optimization, spinal anesthesia, total knee arthroplasty  \nIntroduction  \nTotal knee arthroplasty (TKA) has been a cornerstone in the management of end-stage knee osteoarthritis, offering significant relief to patients suffering from debilitating pain and loss of function. Effective management of fluid administration during TKA is an integral part of perioperative care and a critical aspect of anesthesia management. Maintaining the appropriate balance in fluid levels is critical in order to optimize tissue perfusion, minimize possible complications, and promote a fast postoperative recovery. However, balancing the avoidance of hypovolemia with the prevention of hypervolemia during such a surgical procedure presents a significant challenge, requiring a delicate and precise approach [1] .  \nOver the years, there has been a debate in the field of perioperative care and anesthesia regarding the use of traditional vs. goal-directed fluid management strate","cbCairbZqvPXpTcf","https://ap.wps.com/l/cbCairbZqvPXpTcf","pdf",900399,"English","# Abstract\n# Introduction\n# Materials And Methods\n## How to cite this article\n## Study setting and participants","[{\"question\":\"What is the main goal of goal-directed fluid therapy (GDT) in this study?\",\"answer\":\"To optimize perioperative hemodynamics by tailoring fluid administration to each patient’s individual needs using real-time monitoring.\"},{\"question\":\"Which monitoring system guided GDT for patients undergoing total knee arthroplasty?\",\"answer\":\"The non-invasive ClearSight monitoring system (Edwards Lifesciences Corporation).\"},{\"question\":\"What outcomes differed between the GDT group and standard fluid therapy?\",\"answer\":\"The GDT group received less intraoperative crystalloid, stayed for a shorter period in the post-anesthesia care unit, and maintained more stable mean arterial pressure during the procedure.\"}]","Continuous Hemodynamic Monitoring and Goal-Directed Therapy for Optimization in Total Knee Replacement - A Prospective Observational Study | PDF",1790709675,25]