Trial reportBritish journal of anaesthesia2024
Cardiac index-guided therapy to maintain optimised postinduction cardiac index in high-risk patients having major open abdominal surgery: the multicentre randomised iPEGASUS trial.
Trial report in British journal of anaesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03021525 (Individualized Perioperative Hemodynamic Goal-directed Therapy in Major Abdominal Surgery), which is not on this map. Cited by 24 papers, 3 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.
Individualized Perioperative Hemodynamic Goal-directed Therapy in Major Abdominal Surgery (iPEGASUS-trial) - A Multi-center, Prospective, Randomized Trial
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Agreement of minimally invasive pulse wave analysis with pulmonary artery and transpulmonary thermodilution cardiac output measurements in perioperative and intensive care medicine: a systematic review and meta-analysis.British journal of anaesthesia · 2026Pooled it
- Non-drug perioperative interventions to reduce postoperative pulmonary complications after abdominal surgery: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2026Pooled it
- Incidence and risk factors of acute kidney injury after abdominal surgery: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Decision support guided fluid challenges and stroke volume response during high-risk surgery: a post hoc analysis of a randomized controlled trial.Journal of clinical monitoring and computing · 2025Trial
- The Predictive Paradigm in Perioperative Hemodynamic Management: The Role of Artificial Intelligence in Major Spine Surgery.Journal of clinical medicine · 2026Review
- Development and internal validation of the Low Cardiac Index Score: a simplified bedside tool for continuous intraoperative screening.Journal of clinical monitoring and computing · 2026Article
- Physiology, monitoring, and optimisation of perioperative tissue oxygenation: a narrative review.British journal of anaesthesia · 2026Review
- Preoperative and intraoperative oxygen consumption in patients undergoing lung resection surgery: a retrospective study using cardiopulmonary exercise test and intraoperative data.BMC anesthesiology · 2026Article
- Hemodynamic monitoring: basic principles in operation room and intensive care unit.Journal of clinical monitoring and computing · 2026Review
- Article
- Enhanced recovery after radical cystectomy for bladder cancer: a prospective observational case -control study.BMC urology · 2026Observational
- Non-pharmacological perioperative interventions to prevent postoperative pulmonary complications after abdominal surgery: a protocol for systematic review and meta-analysis.Systematic reviews · 2026Article
- Revisiting the fluid challenge and stroke volume optimisation after induction of general anaesthesia.Annals of intensive care · 2026Article
- Fluid therapy in adults having non-cardiac surgery: A narrative review.Annals of intensive care · 2026Review
- Artificial intelligence-based predictive hemodynamic monitoring in conjunction with goal-directed therapy reduces duration, frequency, and severity of intraoperative hypotension in major maxillofacial and otolaryngological surgery-a prospective randomized controlled pilot trial.Journal of anesthesia, analgesia and critical care · 2025Article
- Goal-directed perioperative haemodynamic therapy: need for a modern perioperative care loop.British journal of anaesthesia · 2025Article
- Current practices in hemodynamic monitoring and management during non-cardiac surgery in Austria.BMC anesthesiology · 2025Article
- Association of intraoperative hypotension and cumulative norepinephrine dose with postoperative acute kidney injury in patients having noncardiac surgery. Response to Br J Anaesth 2025; 134: 1552-3.British journal of anaesthesia · 2025Article
- Attenuation of the plasma volume response to crystalloid fluid used for goal-directed fluid therapy.Annals of intensive care · 2025Article
- Cardiac index-guided therapy to maintain optimised postinduction cardiac index in high-risk patients having major open abdominal surgery. Response to Br J Anaesth 2025; 134: 1550-1.British journal of anaesthesia · 2025Article
Corrections and comments
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Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unclear whether optimising intraoperative cardiac index can reduce postoperative complications. We tested the hypothesis that maintaining optimised postinduction cardiac index during and for the first 8 h after surgery reduces the incidence of a composite outcome of complications within 28 days after surgery compared with routine care in high-risk patients having elective major open abdominal surgery.
methodsIn three German and two Spanish centres, high-risk patients having elective major open abdominal surgery were randomised to cardiac index-guided therapy to maintain optimised postinduction cardiac index (cardiac index at which pulse pressure variation was <12%) during and for the first 8 h after surgery using intravenous fluids and dobutamine or to routine care. The primary outcome was the incidence of a composite outcome of moderate or severe complications within 28 days after surgery.
resultsWe analysed 318 of 380 enrolled subjects. The composite primary outcome occurred in 84 of 152 subjects (55%) assigned to cardiac index-guided therapy and in 77 of 166 subjects (46%) assigned to routine care (odds ratio: 1.87, 95% confidence interval: 1.03-3.39, P=0.038). Per-protocol analyses confirmed the results of the primary outcome analysis.
conclusionsMaintaining optimised postinduction cardiac index during and for the first 8 h after surgery did not reduce, and possibly increased, the incidence of a composite outcome of complications within 28 days after surgery compared with routine care in high-risk patients having elective major open abdominal surgery. Clinicians should not strive to maintain optimised postinduction cardiac index during and after surgery in expectation of reducing complications. CLINICAL
trial registrationNCT03021525.
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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.