Trial reportCritical care (London, England)2015
Closed-loop assisted versus manual goal-directed fluid therapy during high-risk abdominal surgery: a case-control study with propensity matching.
Trial report in Critical care (London, England), 2015. 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 24 papers.
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.
Closed-Loop Fluid Administration System Using Hemodynamic Monitors
Implementation of Computer-Assisted Intraoperative Goal-Directed Fluid Therapy in Major Abdominal Surgery: A Before and After Study
Automated Closed-Loop Versus Restrictive Fluid Therapy in Abdominal Surgery: a Pilot Randomized Controlled Trial
Who cites it
24 citing papers in PubMed.
- Assisted Fluid Management and Sublingual Microvascular Flow During High-Risk Abdominal Surgery: A Randomized Controlled Trial.Anesthesia and analgesia · 2025Trial
- Evaluation of indigenously developed closed-loop automated blood pressure control system (claps): a preliminary study.Journal of clinical monitoring and computing · 2022Trial
- Computer-assisted Individualized Hemodynamic Management Reduces Intraoperative Hypotension in Intermediate- and High-risk Surgery: A Randomized Controlled Trial.Anesthesiology · 2021Trial
- Comparison of cardiac output optimization with an automated closed-loop goal-directed fluid therapy versus non standardized manual fluid administration during elective abdominal surgery: first prospective randomized controlled trial.Journal of clinical monitoring and computing · 2018Trial
- Automated hemodynamic management system for the prevention of hypotension and cardiac output reduction during general anesthesia: preclinical experimental validation.Journal of anesthesia · 2026Article
- Overview of Wearable Healthcare Devices for Clinical Decision Support in the Prehospital Setting.Sensors (Basel, Switzerland) · 2024Review
- Construction of sensitive quality indicators for rapid rehabilitation care of patients after combined pancreaticoduodenectomy.BMC nursing · 2024Article
- MAN VERSUS MACHINE: PROVIDER DIRECTED VERSUS PRECISION AUTOMATED CRITICAL CARE MANAGEMENT IN A PORCINE MODEL OF DISTRIBUTIVE SHOCK.Shock (Augusta, Ga.) · 2024Article
- Artificial Intelligence in Perioperative Planning and Management of Liver Resection.Indian journal of surgical oncology · 2024Review
- Closed-loop anesthesia: foundations and applications in contemporary perioperative medicine.Journal of clinical monitoring and computing · 2024Review
- Article
- Precision Automated Critical Care Management: Closed-loop critical care for the treatment of distributive shock in a swine model of ischemia-reperfusion.The journal of trauma and acute care surgery · 2023Article
- Physiological Modeling of Hemodynamic Responses to Sodium Nitroprusside.Journal of personalized medicine · 2023Article
- Closed-Loop Controlled Fluid Administration Systems: A Comprehensive Scoping Review.Journal of personalized medicine · 2022Article
- Detection of arterial pressure waveform error using machine learning trained algorithms.Journal of clinical monitoring and computing · 2022Article
- The effect of compliance with a perioperative goal-directed therapy protocol on outcomes after high-risk surgery: a before-after study.Journal of clinical monitoring and computing · 2021Article
- Intraoperative hypotension during liver transplant surgery is associated with postoperative acute kidney injury: a historical cohort study.BMC anesthesiology · 2021Article
- Editorial: Fluid Therapy in Animals: Physiologic Principles and Contemporary Fluid Resuscitation Considerations.Frontiers in veterinary science · 2021Article
- Hydroxyethyl starch for perioperative goal-directed fluid therapy in 2020: a narrative review.BMC anesthesiology · 2020Review
- Automated systems for perioperative goal-directed hemodynamic therapy.Journal of anesthesia · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionGoal-directed fluid therapy strategies have been shown to benefit moderate- to high-risk surgery patients. Despite this, these strategies are often not implemented. The aim of this study was to assess a closed-loop fluid administration system in a surgical cohort and compare the results with those for matched patients who received manual management. Our hypothesis was that the patients receiving closed-loop assistance would spend more time in a preload-independent state, defined as percentage of case time with stroke volume variation less than or equal to 12%.
methodsPatients eligible for the study were all those over 18 years of age scheduled for hepatobiliary, pancreatic or splenic surgery and expected to receive intravascular arterial blood pressure monitoring as part of their anesthetic care. The closed-loop resuscitation target was selected by the primary anesthesia team, and the system was responsible for implementation of goal-directed fluid therapy during surgery. Following completion of enrollment, each study patient was matched to a non-closed-loop assisted case performed during the same time period using a propensity match to reduce bias.
resultsA total of 40 patients were enrolled, 5 were ultimately excluded and 25 matched pairs were selected from among the remaining 35 patients within the predefined caliper distance. There was no significant difference in fluid administration between groups. The closed-loop group spent a significantly higher portion of case time in a preload-independent state (95 ± 6% of case time versus 87 ± 14%, P =0.008). There was no difference in case mean or final stroke volume index (45 ± 10 versus 43 ± 9 and 45 ± 11 versus 42 ± 11, respectively) or mean arterial pressure (79 ± 8 versus 83 ± 9). Case end heart rate was significantly lower in the closed-loop assisted group (77 ± 10 versus 88 ± 13, P =0.003).
conclusionIn this case-control study with propensity matching, clinician use of closed-loop assistance resulted in a greater portion of case time spent in a preload-independent state throughout surgery compared with manual delivery of goal-directed fluid therapy.
trial registrationClinicalTrials.gov Identifier: NCT02020863. Registered 19 December 2013.
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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.