Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial [ISRCTN38797445].docVIP

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Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial [ISRCTN38797445].doc

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Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial [ISRCTN38797445]

Available online /content/9/6/R687 Research Open Access Vol 9 No 6 Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial [ISRCT Rupert Pearse, Deborah Dawson, Jayne Fawcett, Andrew Rhodes, R Michael Grounds and E David Bennett Adult Intensive Care Unit, 1st floor St James Wing, St Georges Hospital, Blackshaw Road, London SW17 0QT, UK Corresponding author: Rupert Pearse, rupert.pearse@.uk Received: 8 Sep 2005 Accepted: 30 Sep 2005 Published: 8 Nov 2005 Critical Care 2005, 9:R687-R693 (DOI 10.1186/cc3887) This article is online at: /content/9/6/R687 ? 2005 Pearse et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Goal-directed therapy (GDT) has been shown to improve outcome when commenced before surgery. This requires pre-operative admission to the intensive care unit (ICU). In cardiac surgery, GDT has proved effective when commenced after surgery. The aim of this study was to evaluate the effect of post-operative GDT on the incidence of complications and duration of hospital stay in patients undergoing general surgery. intravenous colloid (1,907 SD ± 878 ml versus 1,204 SD ± 898 ml; p 0.0001) and dopexamine (55 patients (89%) versus 1 patient (2%); p 0.0001). Fewer GDT patients developed complications (27 patients (44%) versus 41 patients (68%); p = 0.003, relative risk 0.63; 95% confidence intervals 0.46 to 0.87). The number of complications per patient was also reduced (0.7 SD ± 0.9 per patient versus 1.5 SD ± 1.5 per patient; p = 0.002). The median duration of hospital stay in the GDT group was significantly reduced (11 days (IQR 7 to 15) versus 14 days (IQR