Trial reportBMC anesthesiology2015
Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement.
Trial report in BMC anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Goal-directed haemodynamic therapy during general anaesthesia for noncardiac surgery: a systematic review and meta-analysis.British journal of anaesthesia · 2022Pooled 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
- Effects of perioperative goal-directed fluid therapy combined with the application of alpha-1 adrenergic agonists on postoperative outcomes: a systematic review and meta-analysis.BMC anesthesiology · 2018Pooled 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
- Pleth variability index versus pulse pressure variation for intraoperative goal-directed fluid therapy in patients undergoing low-to-moderate risk abdominal surgery: a randomized controlled trial.BMC anesthesiology · 2019Trial
- Perioperative Changes in Blood Volume and Fluid Distribution in Total Hip Arthroplasty-A Protocol for a Prospective Single-Center Observational Study.Acta anaesthesiologica Scandinavica · 2026Article
- Article
- Hemodynamic Stability Between Spinal and General Anesthesia in Patient Undergoing Primary Total Knee Arthroplasty: A Retrospective Study.Anesthesiology research and practice · 2025Article
- The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery.World journal of gastrointestinal surgery · 2024Article
- Effects of goal-directed fluid management guided by a non-invasive device on the incidence of postoperative complications in neurosurgery: a pilot and feasibility randomized controlled trial.Perioperative medicine (London, England) · 2023Article
- Review
- Comparison of restrictive fluid therapy with goal-directed fluid therapy for postoperative delirium in patients undergoing spine surgery: a randomized controlled trial.Perioperative medicine (London, England) · 2021Article
- Non-Invasive Continuous Measurement of Haemodynamic Parameters-Clinical Utility.Journal of clinical medicine · 2021Review
- Automated systems for perioperative goal-directed hemodynamic therapy.Journal of anesthesia · 2020Review
- Enhanced recovery pathways in orthopedic surgery.Journal of anaesthesiology, clinical pharmacology · 2019Review
- Iatrogenic hemodilution: a possible cause for avoidable blood transfusions?Critical care (London, England) · 2017Article
- Continuous Non-Invasive Arterial Pressure Assessment during Surgery to Improve Outcome.Frontiers in medicine · 2017Review
- Intraoperative fluid management: Past and future, where is the evidence?Saudi journal of anaesthesiaReview
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of goal directed fluid protocols in intermediate risk patients undergoing hip or knee replacement was studied in few trials using invasive monitoring. For this reason we have implemented two different fluid management protocols, both based on a novel totally non-invasive arterial pressure monitoring device and compared them to the standard (no-protocol) treatment applied before the transition in our academic institution.
methodsThree treatment groups were compared in this prospective study: the observational (CONTROL, N = 40) group before adoption of fluid protocols and two randomized groups after the transition to protocol fluid management with the use of the continuous non-invasive blood pressure monitoring (CNAP®) device. In the PRESSURE group (N = 40) standard variables were used for restrictive fluid therapy. Goal directed fluid therapy using pulse pressure variation was used in the GDFT arm (N = 40). The influence on the rate of postoperative complications, on the hospital length of stay and other parameters was assessed.
resultsBoth protocols were associated with decreased fluid administration and maintained hemodynamic stability. Reduced rate of postoperative infection and organ complications (22 (55 %) vs. 33 (83 %) patients; p = 0.016; relative risk 0.67 (0.49-0.91)) was observed in the GDFT group compared to CONTROL. Lower number of patients receiving transfusion (4 (10 %) in GDFT vs. 17 (43 %) in CONTROL; p = 0.005) might contribute to this observation. No significant differences were observed in other end-points.
conclusionIn our study, the use of the fluid protocol based on pulse pressure variation assessed using continuous non-invasive arterial pressure measurement seems to be associated with a reduction in postoperative complications and transfusion needs as compared to standard no-protocol treatment.
trial registrationACTRN12612001014842.
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