Journal article

Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial: study protocol for a multicentre international trial of cardiac output-guided fluid therapy with low-dose inotrope infusion compared with usual care in patients undergoing major elective gastrointestinal surgery

Mark R Edwards, Gordon Forbes, Neil MacDonald, Vladislav Berdunov, Borislava Mihaylova, Priyanthi Dias, Ann Thomson, Michael PW Grocott, Monty G Mythen, Mike A Gillies, Michael Sander, Tuong D Phan, Lisbeth Evered, Duminda N Wijeysundera, Stuart A McCluskey, Cesar Aldecoa, Javier Ripolles-Melchor, Christoph K Hofer, Hussein Abukhudair, Wojciech Szczeklik Show all

BMJ OPEN | BMJ PUBLISHING GROUP | Published : 2019

Abstract

INTRODUCTION: Postoperative morbidity and mortality in older patients with comorbidities undergoing gastrointestinal surgery are a major burden on healthcare systems. Infections after surgery are common in such patients, prolonging hospitalisation and reducing postoperative short-term and long-term survival. Optimal management of perioperative intravenous fluids and inotropic drugs may reduce infection rates and improve outcomes from surgery. Previous small trials of cardiac-output-guided haemodynamic therapy algorithms suggested a modest reduction in postoperative morbidity. A large definitive trial is needed to confirm or refute this and inform widespread clinical practice. METHODS: The Op..

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