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Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study

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Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study

dc.contributor.author	Salzwedel, Cornelie	es_ES
dc.contributor.author	Puig Bernabeu, Jaume	es_ES
dc.contributor.author	Carstens, Arne	es_ES
dc.contributor.author	Bein, Berthold	es_ES
dc.contributor.author	Molnar, Zsolt	es_ES
dc.contributor.author	Kiss, Krisztian	es_ES
dc.contributor.author	Hussain, Ayyaz	es_ES
dc.contributor.author	Belda Nacher, Francisco Javier	es_ES
dc.contributor.author	Kirov, Mikhail Y	es_ES
dc.contributor.author	Sakka, Samir G	es_ES
dc.contributor.author	Reuter, Daniel A	es_ES
dc.date.accessioned	2015-06-19T07:47:44Z
dc.date.available	2015-06-19T07:47:44Z
dc.date.issued	2013	es_ES
dc.identifier.citation	Critical Care Vol. 17 Issue 5: pp. R191-R191	es_ES
dc.identifier.uri	http://hdl.handle.net/10550/44498
dc.description.abstract	IntroductionSeveral single-center studies and meta-analyses have shown that perioperative goal-directed therapy may significantly improve outcomes in general surgical patients. We hypothesized that using a treatment algorithm based on pulse pressure variation, cardiac index trending by radial artery pulse contour analysis, and mean arterial pressure in a study group (SG), would result in reduced complications, reduced length of hospital stay and quicker return of bowel movement postoperatively in abdominal surgical patients, when compared to a control group (CG).Methods160 patients undergoing elective major abdominal surgery were randomized to the SG (79 patients) or to the CG (81 patients). In the SG hemodynamic therapy was guided by pulse pressure variation, cardiac index trending and mean arterial pressure. In the CG hemodynamic therapy was performed at the discretion of the treating anesthesiologist. Outcome data were recorded up to 28 days postoperatively.ResultsThe total number of complications was significantly lower in the SG (72 vs. 52 complications, p = 0.038). In particular, infection complications were significantly reduced (SG: 13 vs. CG: 26 complications, p = 0.023). There were no significant differences between the two groups for return of bowel movement (SG: 3 vs. CG: 2 days postoperatively, p = 0.316), duration of post anesthesia care unit stay (SG: 180 vs. CG: 180 minutes, p = 0.516) or length of hospital stay (SG: 11 vs. CG: 10 days, p = 0.929).ConclusionsThis multi-center study demonstrates that hemodynamic goal-directed therapy using pulse pressure variation, cardiac index trending and mean arterial pressure as the key parameters leads to a decrease in postoperative complications in patients undergoing major abdominal surgery.Trial registrationClinicalTrial.gov, NCT01401283.	es_ES
dc.title	Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study	es_ES
dc.type	journal article	es_ES
dc.identifier.doi	10.1186/cc12885	es_ES
dc.identifier.idgrec	094601	es_ES