Trial reportCritical care (London, England)2007
Esophageal Doppler-guided fluid management decreases blood lactate levels in multiple-trauma patients: a randomized controlled trial.
Trial report in Critical care (London, England), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 34 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-center Randomized Comparison of a Minimally-invasive Cardiovascular Hemodynamic Optimization (MiCHO) Protocol Versus Early Goal-Directed Therapy (EGDT) in the Management of Septic Shock Patients Presenting to the Emergency Department
Fluid Resuscitation Optimization in Surgical Trauma Patients (FROST)
Bedside Resources to Gauge Intravascular Volume Status in Hypovolemic Infants in the Operating Room
Who cites it
34 citing papers in PubMed, 13 syntheses or guidelines pooled it, 150 citations in OpenAlex.
- Critical Care Ultrasonography for Volume Management: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Trials.Critical care explorations · 2025Pooled it
- Heterogeneity in defining multiple trauma: a systematic review of randomized controlled trials.Critical care (London, England) · 2023Pooled it
- Perioperative restrictive versus goal-directed fluid therapy for adults undergoing major non-cardiac surgery.The Cochrane database of systematic reviews · 2019Pooled it
- Hemodynamic goal-directed therapy and postoperative kidney injury: an updated meta-analysis with trial sequential analysis.Critical care (London, England) · 2019Pooled it
- Is goal-directed fluid therapy based on dynamic variables alone sufficient to improve clinical outcomes among patients undergoing surgery? A meta-analysis.Critical care (London, England) · 2018Pooled it
- Association of conflicts of interest with the results and conclusions of goal-directed hemodynamic therapy research: a systematic review with meta-analysis.Intensive care medicine · 2018Pooled it
- Impact of hemodynamic goal-directed resuscitation on mortality in adult critically ill patients: a systematic review and meta-analysis.Journal of clinical monitoring and computing · 2018Pooled it
- Targeting urine output and 30-day mortality in goal-directed therapy: a systematic review with meta-analysis and meta-regression.BMC anesthesiology · 2017Pooled it
- Intravascular volume therapy in adults: Guidelines from the Association of the Scientific Medical Societies in Germany.European journal of anaesthesiology · 2016Guideline
- Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery.The Cochrane database of systematic reviews · 2012Pooled it
- Clinical review: Volume of fluid resuscitation and the incidence of acute kidney injury - a systematic review.Critical care (London, England) · 2012Pooled it
- Haemodynamic goal-directed therapy and postoperative infections: earlier is better. A systematic review and meta-analysis.Critical care (London, England) · 2011Pooled it
- Hemodynamic optimization in severe trauma: a systematic review and meta-analysis.Revista Brasileira de terapia intensivaPooled it
- Pulse pressure variation guided goal-direct fluid therapy decreases postoperative complications in elderly patients undergoing laparoscopic radical resection of colorectal cancer: a randomized controlled trial.International journal of colorectal disease · 2024Trial
- The influence of goal-directed fluid therapy on the prognosis of elderly patients with hypertension and gastric cancer surgery.Drug design, development and therapy · 2014Trial
- Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study.Critical care (London, England) · 2010Trial
- Comparison of the change in carotid corrected flow time and stroke volume variation for assessing volume responsiveness in general anesthesia patients: a prospective, observational study.Journal of clinical monitoring and computing · 2026Observational
- Eight rules for the haemodynamic management of traumatic brain-injured patients.European journal of anaesthesiology and intensive care · 2023Article
- Review
- Estimation of cardiac output variations induced by hemodynamic interventions using multi-beat analysis of arterial waveform: a comparative off-line study with transesophageal Doppler method during non-cardiac surgery.Journal of clinical monitoring and computing · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionEsophageal Doppler was confirmed as a useful non-invasive tool for management of fluid replacement in elective surgery. The aim of this study was to assess the effect of early optimization of intravascular volume using esophageal Doppler on blood lactate levels and organ dysfunction development in comparison with standard hemodynamic management in multiple-trauma patients.
methodsThis was a randomized controlled trial. Multiple-trauma patients with blood loss of more than 2,000 ml admitted to the intensive care unit (ICU) were randomly assigned to the protocol group with esophageal Doppler monitoring and to the control group. Fluid resuscitation in the Doppler group was guided for the first 12 hours of ICU stay according to the protocol based on data obtained by esophageal Doppler, whereas control patients were managed conventionally. Blood lactate levels and organ dysfunction during ICU stay were evaluated.
resultsEighty patients were randomly assigned to Doppler and 82 patients to control treatment. The Doppler group received more intravenous colloid during the first 12 hours of ICU stay (1,667 +/- 426 ml versus 682 +/- 322 ml; p < 0.0001), and blood lactate levels in the Doppler group were lower after 12 and 24 hours of treatment than in the control group (2.92 +/- 0.54 mmol/l versus 3.23 +/- 0.54 mmol/l [p = 0.0003] and 1.99 +/- 0.44 mmol/l versus 2.37 +/- 0.58 mmol/l [p < 0.0001], respectively). No difference in organ dysfunction between the groups was found. Fewer patients in the Doppler group developed infectious complications (15 [18.8%] versus 28 [34.1%]; relative risk = 0.5491; 95% confidence interval = 0.3180 to 0.9482; p = 0.032). ICU stay in the Doppler group was reduced from a median of 8.5 days (interquartile range [IQR] 6 to16) to 7 days (IQR 6 to 11) (p = 0.031), and hospital stay was decreased from a median of 17.5 days (IQR 11 to 29) to 14 days (IQR 8.25 to 21) (p = 0.045). No significant difference in ICU and hospital mortalities between the groups was found.
conclusionOptimization of intravascular volume using esophageal Doppler in multiple-trauma patients is associated with a decrease of blood lactate levels, a lower incidence of infectious complications, and a reduced duration of ICU and hospital stays.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.