Date of Award

Spring 4-20-2024

Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Dr. Susan Butz

First Committee Member

Dr. Susan Butz

Second Committee Member

Dr. Danielle Winch

Third Committee Member

Dr. Amy Bishop


Goal-directed fluid therapy, Stroke volume variation, Cardiac optimization algorithm, Whipple procedure

Subject Categories

Medicine and Health Sciences


A fundamental responsibility of a certified registered nurse anesthetist includes intraoperative fluid and hemodynamic management. While Enhanced Recovery After Surgery protocols advocate goal-directed fluid therapy, the methodology remains controversial. An algorithmic approach systematically optimizes cardiac function and fluid volume status based on stroke volume variation, cardiac index, and mean arterial pressure. This project aims to evaluate the effects of placing intraoperative guidelines for patients undergoing a Whipple procedure when using a cardiac optimization algorithm to guide fluid and vasopressor management. The outcomes evaluated included the amount of fluids delivered intraoperatively, vasoactive medication administration, urine output, amount of blood transfusions, cardiac and respiratory outcomes, and pancreatic fistulas. The findings of this project present an effective way to manage a patient's fluid status to help improve patient surgical outcomes and postoperative complications.

Acknowledgement 1


Acknowledgement 2


Licensing Permission

Copyright, some rights reserved. Attribution – Noncommercial – No Derivative Works



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