Observational studyCritical care (London, England)2015
Perioperative goal-directed therapy and postoperative outcomes in patients undergoing high-risk abdominal surgery: a historical-prospective, comparative effectiveness study.
Observational study 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 2 registered trials, which are not on this map. Cited by 34 papers, 2 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.
Evaluation of Goal-Directed Intraoperative Hemodynamic Optimization Protocol
Non-invasive Early Goal Directed Therapy in Colorectal Surgery: a Feasibility Study
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Impact of perioperative hemodynamic optimization therapies in surgical patients: economic study and meta-analysis.BMC anesthesiology · 2020Pooled 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
- 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
- Intraoperative intravenous infusion of lidocaine increases total and small vessel densities of sublingual microcirculation: a randomized prospective pilot study.The Journal of international medical research · 2023Trial
- Goal-directed versus Standard Fluid Therapy to Decrease Ileus after Open Radical Cystectomy: A Prospective Randomized Controlled Trial.Anesthesiology · 2020Trial
- Anesthetic Management Using Multiple Closed-loop Systems and Delayed Neurocognitive Recovery: A Randomized Controlled Trial.Anesthesiology · 2020Trial
- Comparison of Hemodynamic Management by Hypotension Prediction Index or Goal-Directed Therapy in Radical Cystectomies: A Prospective Observational Study.Journal of clinical medicine · 2025Article
- Closed-loop anesthesia: foundations and applications in contemporary perioperative medicine.Journal of clinical monitoring and computing · 2024Review
- Article
- Risk factor analysis of postoperative complications in patients undergoing emergency abdominal surgery.Heliyon · 2023Article
- A Pilot Study Assessing a Closed-Loop System for Goal-Directed Fluid Therapy in Abdominal Surgery Patients.Journal of personalized medicine · 2022Article
- Postoperative pulmonary complications and outcomes in cytoreductive surgery for ovarian cancer: a propensity-matched analysis.BMC anesthesiology · 2022Article
- Observational study on fluid therapy management in surgical adult patients.BMC anesthesiology · 2021Observational
- 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
- Comparison of Goal-Directed Fluid Therapy using LiDCOrapid System with Regular Fluid Therapy in Patients Undergoing Spine Surgery as a Randomised Clinical Trial.Romanian journal of anaesthesia and intensive care · 2021Article
- The Effect of Intraoperative Fluid Management According to Stroke Volume Variation on Postoperative Bowel Function Recovery in Colorectal Cancer Surgery.Journal of clinical medicine · 2021Article
- Review of Colonic Anastomotic Leakage and Prevention Methods.Journal of clinical medicine · 2020Review
- Interchangeability between Respiratory Variations of Subclavian Vein and Pulse Pressure Variation in Ventilated Patients in the Operating Room.Turkish journal of anaesthesiology and reanimation · 2020Article
- To compare intraoperative goal directed fluid therapy by trans-oesophageal Doppler vis-à-vis FloTrac™ in patients undergoing living related renal transplantation-a prospective randomised controlled study.Indian journal of anaesthesia · 2020Article
- Hydroxyethyl starch for perioperative goal-directed fluid therapy in 2020: a narrative review.BMC anesthesiology · 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
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPerioperative goal-directed therapy (PGDT) may improve postoperative outcome in high-risk surgery patients but its adoption has been slow. In 2012, we initiated a performance improvement (PI) project focusing on the implementation of PGDT during high-risk abdominal surgeries. The objective of the present study was to evaluate the effectiveness of this intervention.
methodsThis is a historical prospective quality improvement study. The goal of this initiative was to standardize the way fluid management and hemodynamic optimization are conducted during high-risk abdominal surgery in the Departments of Anesthesiology and Surgery at the University of California Irvine. For fluid management, the protocol consisted in standardized baseline crystalloid administration of 3 ml/kg/hour and any additional boluses based on PGDT. The impact of the intervention was assessed on the length of stay in the hospital (LOS) and post-operative complications (NSQIP database).
resultsIn the 1 year pre- and post-implementation periods, 128 and 202 patients were included. The average volume of fluid administered during the case was 9.9 (7.1-13.0) ml/kg/hour in the pre-implementation period and 6.6 (4.7-9.5) ml/kg/hour in the post-implementation period (p < 0.01). LOS decreased from 10 (6-16) days to 7 (5-11) days (p = 0.0001). Based on the multiple linear regression analysis, the estimated coefficient for intervention was 0.203 (SE = 0.054, p = 0.0002) indicating that, with the other conditions being held the same, introducing intervention reduced LOS by 18% (95% confidence interval 9-27%). The incidence of NSQIP complications decreased from 39% to 25% (p = 0.04).
conclusionThese results suggest that the implementation of a PI program focusing on the implementation of PGDT can transform fluid administration patterns and improve postoperative outcome in patients undergoing high-risk abdominal surgeries.
trial registrationClinicaltrials.gov NCT02057653. Registered 17 December 2013.
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.