February 15, 2010Critical CareOpen Access

Goal-directed intraoperative therapy based on autocalibrated arterial pressure waveform analysis reduces hospital stay in high-risk surgical patients: a randomized, controlled trial

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Why the study?

Does intraoperative goal-directed therapy using the FloTrac/Vigileo device reduce hospital stay and complications in high-risk patients undergoing major abdominal surgery?

Population

60 high-risk adult patients undergoing open major abdominal surgery.

Comparison

Enhanced hemodynamic monitoring using a cardiac… vs Standard management protocol based on…

Design

RCT, Randomized preoperatively using a closed envelope system., Complications…

Follow-up

Until hospital discharge

Authors

JMJochen MayerKantonsspital St. Gallen JBJoachim BoldtWest Virginia University AMAndinet MengistuKlinikum Ludwigshafen

Discussion

Member takes

Implication

Supports GDT with FloTrac/Vigileo in high-risk abdominal surgery; confirms benefits of intraoperative hemodynamic optimization.

Structured PICO

Does intraoperative goal-directed therapy using the FloTrac/Vigileo device reduce hospital stay and complications in high-risk patients undergoing major abdominal surgery?

Population

60 high-risk adult patients (ASA physical status III with two or more Lee risk factors) undergoing open major abdominal surgery (intestine, gastric, liver, esophageal resection, Whipple).

Intervention

Enhanced hemodynamic monitoring using a cardiac index-based intraoperative goal-directed therapy (GDT) protocol via the FloTrac/Vigileo device (attempted cardiac index ≥2.5 L·min⁻¹·m⁻²).

Comparator

Standard management protocol based on conventional monitoring (MAP 65-90 mmHg, CVP 8-12 mmHg, urinary output >0.5 mL·kg⁻¹·h⁻¹).

Outcome

Duration of hospital stay.hard clinical

Intraoperative goal-directed hemodynamic optimization using a minimally invasive autocalibrated arterial waveform device significantly reduces hospital length of stay and postoperative complications in high-risk patients undergoing major abdominal surgery.

Limitations

Exclusion of patients with permanent cardiac arrhythmias
Bolus administration of vasoactive drugs may affect accuracy of the arterial waveform-based method
Underpowered to analyze mortality
Patient follow-up was performed until hospital discharge only

Cite This Study

Mayer et al. (2010) studied this question.

synapsesocial.com/papers/6a6f99aee5469ee92be07ff2 https://doi.org/10.1186/cc8875

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Goal-directed intraoperative therapy based on autocalibrated arterial pressure waveform analysis reduces hospital stay in high-risk surgical patients: a randomized, controlled trial

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Goal-directed intraoperative therapy based on autocalibrated arterial pressure waveform analysis reduces hospital stay in high-risk surgical patients: a randomized, controlled trial

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider