Novel hemodynamic protocol using pulse contour cardiac output monitoring in major noncardiac surgery: a prospective, randomized controlled trial

Abstract

Background Perioperative hemodynamic optimization using goal-directed therapy (GDT) mostly has beneficial outcome. Aim In this study, our aim was to determine whether a perioperative hemodynamic protocol based on pulse contour cardiac output monitoring decreases the incidence of postoperative complication and hospital length of stay (HLOS) compared with standard practice. Patients and methods A randomized multicenter clinical trial was conducted. A total of 134 adult patients were scheduled for major noncardiac surgery such as gastrectomy and colorectal surgery. A hemodynamic protocol including vasoactive drugs and fluid boluses based on pulse contour cardiac output monitoring was compared with standard practice. Patients were followed until hospital discharge. Results Fluid administration was similar except for the number of colloid boluses (1.1±0.3 in control vs. 1.8±0.21 in GDT, with P Conclusion The use of GDT is not associated with decrease in HLOS or postoperative complications except for a reduction in the need for reoperation.