HARMONY in Perioperative Care
HAemodynamic, VasopRessor and MONitoring StrategY in Perioperative Care
The European Society of Anaesthesiology and Intensive Care supports and facilitates meetings and communication between Research Groups.
Who we are
Every day, across operating theatres and intensive care units worldwide, clinicians face one of the most consequential decisions in perioperative medicine: how to support a patient’s circulation when it falters. Despite the high frequency and clinical importance of vasopressor use and haemodynamic monitoring in the perioperative setting, practice varies widely — and the evidence to guide it remains incomplete.
The HARMONY Research Group was established within the European Society of Anaesthesiology and Intensive Care (ESAIC) to change that. We are an international team of clinicians and researchers united by a shared commitment to improving perioperative haemodynamic management — for every patient, in every setting.
Our group builds directly on the foundation of the SQUEEZE study (Vasopressor use after noncardiac surgery: an international observational study, British Journal of Anaesthesia, 2025), a landmark international investigation that documented striking variation in vasopressor use across more than 200 centres worldwide. SQUEEZE demonstrated both the scale of the problem and the power of global collaboration to illuminate it. HARMONY is the next step.
Our Research Questions
We are driven by questions that matter at the bedside:
- What are the current patterns of haemodynamic support and vasopressor use across cardiac and non-cardiac surgery — and why do they vary so much?
- How are haemodynamic monitoring technologies being used in perioperative practice today?
- How do different management strategies affect organ perfusion and postoperative recovery?
- Which patient-specific factors should guide vasopressor choice and dosing?
- Can standardised, individualised protocols reduce practice variation and improve patient outcomes?
Our Mission and Goals for 2025–2030
Over the next five years, HARMONY will pursue a broad and ambitious research agenda:
Expanding observational research — We will build on the SQUEEZE methodology to study haemodynamic support and monitoring in populations previously excluded, including cardiac surgical, obstetric, and transplant patients.
Developing interventional trials — Informed by our observational findings, we will design and conduct clinical trials to test novel strategies, including non-catecholamine vasopressors such as angiotensin-II.
Advancing monitoring science — In collaboration with industry and academic partners, we will evaluate new systems for haemodynamic monitoring and AI-assisted perioperative decision support.
Supporting translational research — We will investigate the mechanisms underpinning intra- and postoperative vasodilation, including the role of inflammation, to identify the most effective therapeutic targets.
Educating the community — Through ESAIC, we will develop haemodynamic-focused continuing professional development resources relevant to the entire ESAIC membership.
Building partnerships — We actively collaborate with leading societies including EACTAIC, IACA, and the POQI Group to harmonise efforts and maximise impact across Europe and beyond.Informing guidelines — Working alongside the ESAIC guideline group, we will target evidence gaps in perioperative haemodynamic monitoring and therapy to support the development of future clinical recommendations.
Selected Key Publications
- Jammer I, Martin P, Wunsch H et al. Vasopressor use after noncardiac surgery: an international observational study. British Journal of Anaesthesia, 2025.
- Creagh-Brown B, Wunsch H, Martin P et al. The incidence of postoperative vasopressor usage: protocol for SQUEEZE. Perioperative Medicine, 2023.
- Edwards MR, Kunst G, Forni LG et al. Perioperative Quality Initiative consensus statement on goal-directed haemodynamic therapy. British Journal of Anaesthesia, 2025.
- OPTIMISE II Trial Group. Cardiac output-guided haemodynamic therapy for patients undergoing major gastrointestinal surgery. BMJ, 2024.
- Ripollés-Melchor J et al. Hemodynamic Management Guided by the Hypotension Prediction Index in Abdominal Surgery: A Multicenter Randomized Clinical Trial. Anesthesiology, 2025.
Contact Person: research@esaic.org ; ib.jammer@helse-bergen.no
| Role | Name | Institution | Country |
| Chair | Dr. Ib Jammer | Haukeland University Hospital | Norway |
| Vice-Chair | Prof. Ben Creagh-Brown | Royal Surrey Hospital / University of Surrey | UK |
| Member | Dr. Denise Veelo | Amsterdam UMC | Netherlands |
| Member | Prof. Gudrun Kunst | King’s College London | UK |
| Member | Prof. Hannah Wunsch | Weill Cornell Medicine | USA |
| Member | Prof. Mark Edwards | University Hospital Southampton | UK |
| Member | Dr. Matteo Parotto | Toronto General Hospital | Canada |
| Member | Prof. Michael Sander | UKGM Giessen | Germany |
| Member | Dr. Morten Vester-Andersen | Copenhagen University Hospital | Denmark |
| Member | Dr. Ned Douglas | Royal Melbourne Hospital | Australia |
| Member | Dr. Simon Davies | York Hospitals NHS Foundation Trust | UK |
| Member | Dr. Andreja Möller Petrun | University Medical Centre Maribor | Slovenia |
| Member | Dr. Martin Ingi Sigurdsson | University of Reykjavik | Iceland |
| Member | Dr. Javi Ripolles | Universidad Complutense de Madrid | Spain |
