Protective Hemodynamics

The hemodynamic management of critically ill and perioperative patients represents a critical research area that bridges anesthesia, intensive care, and cardiovascular physiology. Hemodynamics is pivotal in maintaining tissue perfusion and organ function, yet the optimal strategies to balance blood pressure targets, fluid therapy, and vasopressor use remain highly debated. The concept of Protective Hemodynamics, encapsulated in the C.L.E.A.R. framework (Customize Targets, Limit Catecholamines, Enhance Flow, Adjust Fluid Balance, Resolve Underlying Conditions), advocates for a holistic, patient-centered strategy. This Research Topic seeks to consolidate and expand the understanding of hemodynamic strategies by inviting contributions that address the nuances of managing cardiovascular stability, organ perfusion, and fluid balance across diverse clinical settings. By fostering interdisciplinary collaboration, this collection aims to advance the science of hemodynamics and its practical applications in critical care and perioperative medicine.

The goal of this Research Topic is to address the persistent challenges in achieving optimal hemodynamic management in critically ill and perioperative patients. Despite significant advancements, the balance between ensuring adequate organ perfusion and minimizing the risks of over-intervention—such as excessive fluid administration or vasopressor use—remains a central issue in clinical practice. Current approaches often rely on standardized blood pressure targets or interventions, which may not reflect the complex and dynamic needs of individual patients.

This Research Topic aims to explore innovative strategies and evidence-based practices that promote personalized hemodynamic management. By integrating insights from clinical trials, advanced monitoring techniques, and multidisciplinary perspectives, this collection seeks to redefine how cardiovascular stability and tissue perfusion are achieved. Contributions will include studies focusing on the interplay between macro- and microcirculation, the impact of fluid and vasopressor therapies, and novel approaches to tailoring interventions to specific patient populations. Ultimately, the goal is to advance understanding and improve outcomes for patients undergoing critical care and perioperative management through the dissemination of cutting-edge research and clinical insights.

This Research Topic invites contributions that explore the complexities and advancements in hemodynamic management across critical care and perioperative settings. We welcome studies that delve into the optimization of cardiovascular stability, tissue perfusion, and organ protection through innovative strategies and technologies. Key themes include:

• Personalized hemodynamic management approaches in critically ill and surgical patients.

• Interactions between macro- and microcirculation and their impact on clinical outcomes.

• Advances in monitoring technologies for hemodynamic assessment.

• Optimization of fluid therapy, vasopressor use, and alternative pharmacological interventions.

• Outcome-focused studies on novel therapeutic strategies and interventions.

We encourage submissions of original research, systematic reviews, meta-analyses, clinical trials, and expert opinion pieces. Contributions may address fundamental research, applied clinical practices, or translational approaches. By bringing together diverse perspectives, this Research Topic aims to provide a comprehensive resource for clinicians and researchers, advancing the science and practice of hemodynamic management.