Key result
Multi-parametric perioperative goal directed therapy reduced 28-day mortality and morbidity compared to standard care (28.2% vs 46.4%; RR 0.61; 95% CI 0.39-0.95; P=0.03).
Why the study?
Perioperative goal-directed therapy protocols are often based on stroke volume alone rather than multi-parametric functional hemodynamic variables.
Does multi-parametric perioperative goal directed therapy reduce 28-day mortality and morbidity in intermediate-to-high risk patients undergoing gastrointestinal surgery?
Population
140 intermediate-to-high risk patients undergoing gastrointestinal surgery
Comparison
Multi-parametric pGDT based on esophageal Doppler variables vs standard care
Design
Monocentric randomized controlled trial
Follow-up
28 days
Authors
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Supports multi-parametric goal-directed therapy in intermediate-to-high risk GI surgery; extends perioperative optimization evidence.
RCT (n=140)
randomized
No
Does multi-parametric perioperative goal directed therapy reduce 28-day mortality and morbidity in intermediate-to-high risk patients undergoing gastrointestinal surgery?
Relative Risk: 0.61 (95% CI 0.39–0.95)
Absolute Event Rate: 28.2% vs 46.4%
p-value: p=0.03
Multi-parametric perioperative goal-directed therapy based on esophageal Doppler variables significantly reduces 28-day postoperative complications in intermediate-to-high risk patients undergoing gastrointestinal surgery.
Szturz et al. (2019) conducted an RCT in intermediate-to-high risk patients undergoing gastrointestinal surgery (n=140). Multi-parametric perioperative goal directed therapy (pGDT) vs. Standard care was evaluated on 28 days mortality and morbidity defined as occurrence of any defined complication (RR 0.61, 95% CI 0.39-0.95, p=0.03). Multi-parametric perioperative goal directed therapy reduced 28-day mortality and morbidity compared to standard care (28.2% vs 46.4%; RR 0.61; 95% CI 0.39-0.95; P=0.03).
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