Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial
Abstract Background Early goal-directed therapy (EGDT) using FloTrac reduced length of stay (LOS) in intensive care (ICU) and hospital among patients undergoing coronary artery bypass graft (CABG) with a cardiopulmonary bypass. However, this platform in off-pump CABG (OPCAB) has received scant atten...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-01933-4 |
| _version_ | 1818082484282195968 |
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| author | Sirirat Tribuddharat Thepakorn Sathitkarnmanee Kriangsak Ngamsaengsirisup Sanpicha Sornpirom |
| author_facet | Sirirat Tribuddharat Thepakorn Sathitkarnmanee Kriangsak Ngamsaengsirisup Sanpicha Sornpirom |
| author_sort | Sirirat Tribuddharat |
| collection | DOAJ |
| description | Abstract Background Early goal-directed therapy (EGDT) using FloTrac reduced length of stay (LOS) in intensive care (ICU) and hospital among patients undergoing coronary artery bypass graft (CABG) with a cardiopulmonary bypass. However, this platform in off-pump CABG (OPCAB) has received scant attention, so we evaluated the efficacy of EGDT using FloTrac/EV1000 as a modality for improving postoperative outcomes in patients undergoing OPCAB. Methods Forty patients undergoing OPCAB were randomized to the EV1000 or Control group. The Control group received fluid, inotropic, or vasoactive drugs (at the discretion of the attending anesthesiologist) to maintain a mean arterial pressure 65–90 mmHg; central venous pressure 8–12 mmHg; urine output ≥ 0.5 mL kg−1 h−1; SpO2 > 95%; and hematocrit ≥ 30%. The EV1000 group achieved identical targets using information from the FloTrac/EV1000. The goals included stroke volume variation < 13%; cardiac index (CI) of 2.2–4.0 L min−1 m−2; and systemic vascular resistance index of 1500–2500 dynes s−1 cm−5 m−2. Results The EV1000 group had a shorter LOS in ICU (mean difference − 1.3 d, 95% CI − 1.8 to − 0.8; P < 0.001). The ventilator time for both groups was comparable (P = 0.316), but the hospital stay for the EV1000 group was shorter (mean difference − 1.4 d, 95% CI − 2.1 to − 0.6; P < 0.001). Conclusions EGDT using FloTrac/EV1000 compared to conventional protocol reduces LOS in ICU and hospital among patients undergoing OPCAB. Trial registration This study was retrospectively registered at www.ClinicalTrials.gov (NCT04292951) on 3 March 2020. |
| first_indexed | 2024-12-10T19:22:50Z |
| format | Article |
| id | doaj.art-0f8835c40d7e41258d6f2f4bc0c4be52 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-10T19:22:50Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-0f8835c40d7e41258d6f2f4bc0c4be522022-12-22T01:36:26ZengBMCJournal of Cardiothoracic Surgery1749-80902022-08-011711710.1186/s13019-022-01933-4Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trialSirirat Tribuddharat0Thepakorn Sathitkarnmanee1Kriangsak Ngamsaengsirisup2Sanpicha Sornpirom3Department of Anesthesiology, Faculty of Medicine, Khon Kaen UniversityDepartment of Anesthesiology, Faculty of Medicine, Khon Kaen UniversityDepartment of Anesthesiology, Faculty of Medicine, Khon Kaen UniversityCardiothoracic Intensive Care Unit, Faculty of Medicine, Khon Kaen UniversityAbstract Background Early goal-directed therapy (EGDT) using FloTrac reduced length of stay (LOS) in intensive care (ICU) and hospital among patients undergoing coronary artery bypass graft (CABG) with a cardiopulmonary bypass. However, this platform in off-pump CABG (OPCAB) has received scant attention, so we evaluated the efficacy of EGDT using FloTrac/EV1000 as a modality for improving postoperative outcomes in patients undergoing OPCAB. Methods Forty patients undergoing OPCAB were randomized to the EV1000 or Control group. The Control group received fluid, inotropic, or vasoactive drugs (at the discretion of the attending anesthesiologist) to maintain a mean arterial pressure 65–90 mmHg; central venous pressure 8–12 mmHg; urine output ≥ 0.5 mL kg−1 h−1; SpO2 > 95%; and hematocrit ≥ 30%. The EV1000 group achieved identical targets using information from the FloTrac/EV1000. The goals included stroke volume variation < 13%; cardiac index (CI) of 2.2–4.0 L min−1 m−2; and systemic vascular resistance index of 1500–2500 dynes s−1 cm−5 m−2. Results The EV1000 group had a shorter LOS in ICU (mean difference − 1.3 d, 95% CI − 1.8 to − 0.8; P < 0.001). The ventilator time for both groups was comparable (P = 0.316), but the hospital stay for the EV1000 group was shorter (mean difference − 1.4 d, 95% CI − 2.1 to − 0.6; P < 0.001). Conclusions EGDT using FloTrac/EV1000 compared to conventional protocol reduces LOS in ICU and hospital among patients undergoing OPCAB. Trial registration This study was retrospectively registered at www.ClinicalTrials.gov (NCT04292951) on 3 March 2020.https://doi.org/10.1186/s13019-022-01933-4Early goal-directed therapyOff-pump coronary artery bypass graftLength of stayIntensive care unitHospital |
| spellingShingle | Sirirat Tribuddharat Thepakorn Sathitkarnmanee Kriangsak Ngamsaengsirisup Sanpicha Sornpirom Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial Journal of Cardiothoracic Surgery Early goal-directed therapy Off-pump coronary artery bypass graft Length of stay Intensive care unit Hospital |
| title | Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial |
| title_full | Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial |
| title_fullStr | Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial |
| title_full_unstemmed | Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial |
| title_short | Efficacy of early goal-directed therapy using FloTrac/EV1000 to improve postoperative outcomes in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial |
| title_sort | efficacy of early goal directed therapy using flotrac ev1000 to improve postoperative outcomes in patients undergoing off pump coronary artery bypass surgery a randomized controlled trial |
| topic | Early goal-directed therapy Off-pump coronary artery bypass graft Length of stay Intensive care unit Hospital |
| url | https://doi.org/10.1186/s13019-022-01933-4 |
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