Perioperative medicine & outcomes
Cardiac output-guided haemodynamic therapy for patients undergoing major gastrointestinal surgery: OPTIMISE II randomised clinical trial
Primary resultResult — go to the resultAdjusted odds ratio 1.03 95% CI 0.84–1.25Authors' conclusion
This 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.
Study context
- Population
- Adults aged ≥65 years, ASA physical status II or greater, undergoing major elective gastrointestinal surgery; 55 hospitals worldwide, January 2017–September 2022
- Participants
- 2,498 adults
- Comparison
- Intervention vs Usual care
- Primary endpoint
- Postoperative infection
- Follow-up
- Within 30 days of randomisation
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
Adjusted odds ratio
1.03
95% CI 0.84–1.25
P = 0.81
Events by treatment group
Intervention vs Usual care
aOR 1.03 (95% CI 0.84–1.25); P = 0.81
Secondary outcomes
Other secondary outcomes (AKI within 30 days, mortality within 180 days)
- Other secondary outcomes did not differ
Safety
| Outcome | Intervention | Usual care | aOR (CI) | P value | |
|---|---|---|---|---|---|
| Acute cardiac events · within 24 hours | 3.0% | 1.7% | 1.82 (1.06–3.13) | P = 0.03 | |
| Acute cardiac events · within 30 days | 6.8% | 6.3% | 1.06 (0.77–1.47) | P = 0.71 | |
| 0.20.5125Adjusted odds ratio (log scale) |
- Acute cardiac events: difference primarily due to increased incidence of arrhythmias in intervention patients
Original publication
Cardiac output-guided haemodynamic therapy for patients undergoing major gastrointestinal surgery: OPTIMISE II randomised clinical trial. BMJ. Published 3 December 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →