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The programs used are currently undergoing optimisation but can be made available on request.
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A further subgroup analysis will assess if there is a difference of safety between a) elective patients who will receive preoperative haemoglobin optimisation compared to b) anemic patients who will not undergo preoperative haemoglobin optimisation due to failed postponement of surgery in case of surgical urgency or non-elective surgery, respectively.
All adult patients admitted to the ICU after surgery who underwent protocolised haemodynamic optimisation were included.
A series of articles published in Critical Care in 2007 have investigated further possible applications of PPV: intraoperative fluid optimisation of patients undergoing cardiac surgery or high-risk surgery.
Using the ScvO2 as a potential target variable for haemodynamic optimisation is attractive because central venous catheterisation is routinely used in high-risk patients undergoing major surgery, ScvO2 can be screened, pre-emptive treatment is possible, and no major changes are necessary for the infrastructure in the operation area.
Far more importantly, preventive preoperative evaluation and optimisation of pulmonary health in addition to implementation of preoperative smoking cessation programmes in patients undergoing elective surgery have the likelihood of reducing the increased mortality risk.
These results are in agreement with other fluid optimisation studies in which the use of more invasive haemodynamic parameters, such as GEDVI in patients undergoing cardiac surgery, was associated with a reduced requirement of vasoactive drugs and a shorter duration of mechanical ventilation and ICU stay [ 26].
Hemodynamic optimisation based on flow variables allows an early detection and correction of possible occult organ hypoperfusion in patients undergoing major surgery.
undergoing CS.
Taken together with previous work, the results of this study pose the question as to whether pre-operative optimisation of patient physiology and down-regulation of the systemic inflammatory response may be associated with improvements in long-term survival in patients undergoing surgery for colorectal cancer.
All participants will undergo a period of structured treatment optimisation prior to the study intervention and receive equal attention from study team during each study arm.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com