Multi-parametric functional hemodynamic optimization improves postsurgical outcome after intermediate risk open gastrointestinal surgery: a randomized controlled trial
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61988987%3A17110%2F19%3AA2001ZB5" target="_blank" >RIV/61988987:17110/19:A2001ZB5 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11140/19:10382705 RIV/00843989:_____/19:E0107973
Result on the web
<a href="https://www.minervamedica.it/en/getfreepdf/GDPn9V0%252FbTKxOhttYMNLyBhnsiQ3QL%252B%252BDvY631IXAcEJRJIrsaw6LMan01jcnnsgfetBmGhx8h%252FOrVhw4vKBJA%253D%253D/R02Y2019N03A0244.pdf" target="_blank" >https://www.minervamedica.it/en/getfreepdf/GDPn9V0%252FbTKxOhttYMNLyBhnsiQ3QL%252B%252BDvY631IXAcEJRJIrsaw6LMan01jcnnsgfetBmGhx8h%252FOrVhw4vKBJA%253D%253D/R02Y2019N03A0244.pdf</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.23736/S0375-9393.18.12467-9" target="_blank" >10.23736/S0375-9393.18.12467-9</a>
Alternative languages
Result language
angličtina
Original language name
Multi-parametric functional hemodynamic optimization improves postsurgical outcome after intermediate risk open gastrointestinal surgery: a randomized controlled trial
Original language description
ACKGROUND: Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopressors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi-parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery. METHODS: Intermediate-to-high risk patients undergoing gastrointestinal surgery were randomized to standard care (control) or multi-parametric pGDT (intervention). Postoperative complications and death rate as well as hospital length of stay were assessed as primary and secondary outcomes. RESULTS: Overall, 140 patients (intervention, N.=71, and control, N.=69) were included and randomized out of 197 eligible. Higher vasoactive/inotropic drug use and lower fluid balance were observed in the intervention group leading to favorable hemodynamic profile. The pGDT intervention was associated with improved primary outcome (28 days mortality and morbidity defined as occurrence of any defined complication) - 20 patients (28.2%) versus 32 (46.4%) in the control group (P=0.036); RR 0.61 (95% CI: 0.39-0.95), P=0.03. No differences in mortality and hospital length of stay were observed between groups. CONCLUSIONS: In this monocentric trial the multi-parametric pGDT protocol based on domain specific functional hemodynamic parameters was associated with lower rate of postoperative complications in intermediate-to-high risk patients undergoing scheduled gastrointestinal procedures.
Czech name
—
Czech description
—
Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
—
OECD FORD branch
30221 - Critical care medicine and Emergency medicine
Result continuities
Project
—
Continuities
S - Specificky vyzkum na vysokych skolach
Others
Publication year
2019
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
EDIZIONI MINERVA MEDICA
ISSN
0375-9393
e-ISSN
1827-1596
Volume of the periodical
85
Issue of the periodical within the volume
3
Country of publishing house
IT - ITALY
Number of pages
11
Pages from-to
244-254
UT code for WoS article
000461426300006
EID of the result in the Scopus database
2-s2.0-85051423101