Trial reportBMJ (Clinical research ed.)2024
Cardiac output-guided haemodynamic therapy for patients undergoing major gastrointestinal surgery: OPTIMISE II randomised clinical trial.
Trial report in BMJ (Clinical research ed.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 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
- Hypotension prediction index smart alerts and trends to improve compliance with goal-directed hemodynamic therapy: a feasibility study.BMC anesthesiology · 2025Trial
- Association Between Adherence to a Locally Adapted Enhanced Recovery After Surgery Pathway and Perioperative Outcomes After Open Abdominal Aortic Aneurysm Repair: A Retrospective Cohort Study.Journal of clinical medicine · 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
- Advances in the postoperative care of the liver transplant recipient.Current opinion in critical care · 2026Review
- Article
- Perioperative Vasopressor Management in Noncardiac Surgical Patients.Anesthesiology · 2026Article
- 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
- Exposure-based stratification of postoperative complications in major cardiac surgical procedures: a retrospective cohort study using the MOVER database.Frontiers in cardiovascular medicine · 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
- Vasopressor use after noncardiac surgery: an international observational study.British journal of anaesthesia · 2025Observational
- Goal-directed perioperative haemodynamic therapy: need for a modern perioperative care loop.British journal of anaesthesia · 2025Article
- Haemodynamic monitoring and management during non-cardiac surgery: a survey among German anaesthesiologists.Journal of clinical monitoring and computing · 2025Article
- Current practices in hemodynamic monitoring and management during non-cardiac surgery in Austria.BMC anesthesiology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
Abstract
objectivesTo evaluate the clinical effectiveness and safety of a perioperative algorithm for cardiac output-guided haemodynamic therapy in patients undergoing major gastrointestinal surgery.
designMulticentre randomised controlled trial.
settingSurgical services of 55 hospitals worldwide.
participants2498 adults aged ≥65 years with an American Society of Anesthesiologists physical status classification of II or greater and undergoing major elective gastrointestinal surgery, recruited between January 2017 and September 2022.
interventionsParticipants were assigned to minimally invasive cardiac output-guided intravenous fluid therapy with low dose inotrope infusion during and four hours after surgery, or to usual care without cardiac output monitoring.
main outcome measuresThe primary outcome was postoperative infection within 30 days of randomisation. Safety outcomes were acute cardiac events within 24 hours and 30 days. Secondary outcomes were acute kidney injury within 30 days and mortality within 180 days.
resultsIn 2498 patients (mean age 74 (standard deviation 6) years, 57% women), the primary outcome occurred in 289/1247 (23.2%) intervention patients and 283/1247 (22.7%) usual care patients (adjusted odds ratio 1.03 (95% confidence interval 0.84 to 1.25); P=0.81). Acute cardiac events within 24 hours occurred in 38/1250 (3.0%) intervention patients and 21/1247 (1.7%) usual care patients (adjusted odds ratio 1.82 (1.06 to 3.13); P=0.03). This difference was primarily due to an increased incidence of arrhythmias among intervention patients. Acute cardiac events within 30 days occurred in 85/1249 (6.8%) intervention patients and 79/1247 (6.3%) usual care patients (adjusted odds ratio 1.06 (0.77 to 1.47); P=0.71). Other secondary outcomes did not differ.
conclusionsThis clinical effectiveness trial in patients undergoing major elective gastrointestinal surgery did not provide evidence that cardiac output-guided intravenous fluid therapy with low dose inotrope infusion could reduce the incidence of postoperative infections. The intervention was associated with an increased incidence of acute cardiac events within 24 hours, in particular tachyarrhythmias. Based on these findings, the routine use of this treatment approach in unselected patients is not recommended.
trial registrationISRCTN Registry ISRCTN39653756.
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