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Continuous cardiac index trending (ProAQT) via a radial arterial line versus standard care in general surgical patients

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Continuous cardiac index trending (ProAQT) via a radial arterial line versus standard care in general surgical patients

dc.contributor.advisor	Belda Nacher, Francisco Javier
dc.contributor.advisor	Reuter, Daniel A
dc.contributor.author	Puig Bernabeu, Jaume
dc.contributor.other	Departament de Cirurgia	es_ES
dc.date.accessioned	2015-06-29T06:40:15Z
dc.date.available	2015-06-30T03:45:05Z
dc.date.issued	2015	es_ES
dc.date.submitted	29-06-2015	es_ES
dc.identifier.uri	http://hdl.handle.net/10550/44778
dc.description.abstract	Introduction Several 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, 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. Methods 160 patients undergoing elective major abdominal surgery were randomized to the Study Group (79 patients) or to the Control Group (81 patients). In the Study Group hemodynamic therapy was guided by pulse pressure variation, cardiac index trending and mean arterial pressure. In the Control Group hemodynamic therapy was performed at the discretion of the treating anesthesiologist. Outcome data were recorded up to 28 days postoperatively. Results The total number of complications was significantly lower in the Study Group (72 vs. 52 complications, p = 0.038). In particular, infectious complications were significantly reduced (Study Group: 13 vs. Control Group: 26 complications, p = 0.023). There were no significant differences between the two groups for return of bowel movement (Study Group: 3 vs. Control Group: 2 days postoperatively, p = 0.316), duration of post anesthesia care unit stay (Study Group: 180 vs. Control Group: 180 minutes, p = 0.516) or length of hospital stay (Study Group: 11 vs. Control Group: 10 days, p = 0.929). Conclusions This 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.	es_ES
dc.format.extent	140 p.	es_ES
dc.language.iso	es	es_ES
dc.subject	Hemodynamic	es_ES
dc.subject	GDT	es_ES
dc.subject	Cardiac Index	es_ES
dc.subject	Perioperative complications	es_ES
dc.title	Continuous cardiac index trending (ProAQT) via a radial arterial line versus standard care in general surgical patients	es_ES
dc.type	doctoral thesis	es_ES
dc.subject.unesco	UNESCO::CIENCIAS MÉDICAS	es_ES
dc.embargo.terms	0 days	es_ES