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Effect of intraoperative personalized goal-directed hemodynamic management on acute myocardial injury in high-risk patients having major abdominal surgery: a post-hoc secondary analysis of a randomized clinical trial

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Effect of intraoperative personalized goal-directed hemodynamic management on acute myocardial injury in high-risk patients having major abdominal surgery: a post-hoc secondary analysis of a randomized clinical trial. / Kouz, Karim; Bergholz, Alina; Diener, Oliver; Leistenschneider, Maximilian; Thompson, Christina; Pichotka, Friederike; Trepte, Constantin; Schwedhelm, Edzard; Renné, Thomas; Krause, Linda; Nicklas, Julia Y; Saugel, Bernd.

In: J CLIN MONIT COMPUT, Vol. 36, No. 6, 12.2022, p. 1775-1783.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Kouz, K, Bergholz, A, Diener, O, Leistenschneider, M, Thompson, C, Pichotka, F, Trepte, C, Schwedhelm, E, Renné, T, Krause, L, Nicklas, JY & Saugel, B 2022, 'Effect of intraoperative personalized goal-directed hemodynamic management on acute myocardial injury in high-risk patients having major abdominal surgery: a post-hoc secondary analysis of a randomized clinical trial', J CLIN MONIT COMPUT, vol. 36, no. 6, pp. 1775-1783. https://doi.org/10.1007/s10877-022-00826-0

APA

Kouz, K., Bergholz, A., Diener, O., Leistenschneider, M., Thompson, C., Pichotka, F., Trepte, C., Schwedhelm, E., Renné, T., Krause, L., Nicklas, J. Y., & Saugel, B. (2022). Effect of intraoperative personalized goal-directed hemodynamic management on acute myocardial injury in high-risk patients having major abdominal surgery: a post-hoc secondary analysis of a randomized clinical trial. J CLIN MONIT COMPUT, 36(6), 1775-1783. https://doi.org/10.1007/s10877-022-00826-0

Vancouver

Kouz K, Bergholz A, Diener O, Leistenschneider M, Thompson C, Pichotka F et al. Effect of intraoperative personalized goal-directed hemodynamic management on acute myocardial injury in high-risk patients having major abdominal surgery: a post-hoc secondary analysis of a randomized clinical trial. J CLIN MONIT COMPUT. 2022 Dec;36(6):1775-1783. https://doi.org/10.1007/s10877-022-00826-0

Bibtex

@article{835fbd14ed284a22b680cabed2671d3d,
title = "Effect of intraoperative personalized goal-directed hemodynamic management on acute myocardial injury in high-risk patients having major abdominal surgery: a post-hoc secondary analysis of a randomized clinical trial",
abstract = "Acute myocardial injury is common after noncardiac surgery and associated with mortality. Impaired intraoperative cardiovascular dynamics are a risk factor for acute myocardial injury. Optimizing intraoperative cardiovascular dynamics may thus reduce acute myocardial injury. We aimed to investigate the effect of intraoperative personalized goal-directed hemodynamic management on the incidence of acute myocardial injury. We hypothesized that personalized goal-directed hemodynamic management reduces the incidence of acute myocardial injury compared to routine hemodynamic management in high-risk patients having major abdominal surgery. We performed a post-hoc secondary analysis of a randomized clinical trial including 180 high-risk major abdominal surgery patients that were randomized to personalized goal-directed hemodynamic management or routine hemodynamic management. We compared the incidences of acute myocardial injury-defined according to the Fourth Universal Definition of Myocardial Infarction (2018)-between patients randomized to personalized goal-directed hemodynamic management or routine hemodynamic management by calculating the relative and absolute risk reduction together with 95% Wald confidence intervals and P values. Acute myocardial injury occurred in 4 of 90 patients (4%) in the personalized goal-directed hemodynamic management group and in 12 of 90 patients (13%) in the routine hemodynamic management group (relative risk: 0.33, 95% confidence interval: 0.11 to 0.99, P = 0.036; absolute risk reduction: - 9%, 95% confidence interval: - 17% to - 0.68%, P = 0.034). In this post-hoc secondary analysis, intraoperative personalized goal-directed hemodynamic management reduced the incidence of acute myocardial injury compared to routine hemodynamic management in high-risk patients having major abdominal surgery. This needs to be confirmed in larger prospective trials.",
author = "Karim Kouz and Alina Bergholz and Oliver Diener and Maximilian Leistenschneider and Christina Thompson and Friederike Pichotka and Constantin Trepte and Edzard Schwedhelm and Thomas Renn{\'e} and Linda Krause and Nicklas, {Julia Y} and Bernd Saugel",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = dec,
doi = "10.1007/s10877-022-00826-0",
language = "English",
volume = "36",
pages = "1775--1783",
journal = "J CLIN MONIT COMPUT",
issn = "1387-1307",
publisher = "Springer Netherlands",
number = "6",

}

RIS

TY - JOUR

T1 - Effect of intraoperative personalized goal-directed hemodynamic management on acute myocardial injury in high-risk patients having major abdominal surgery: a post-hoc secondary analysis of a randomized clinical trial

AU - Kouz, Karim

AU - Bergholz, Alina

AU - Diener, Oliver

AU - Leistenschneider, Maximilian

AU - Thompson, Christina

AU - Pichotka, Friederike

AU - Trepte, Constantin

AU - Schwedhelm, Edzard

AU - Renné, Thomas

AU - Krause, Linda

AU - Nicklas, Julia Y

AU - Saugel, Bernd

N1 - © 2022. The Author(s).

PY - 2022/12

Y1 - 2022/12

N2 - Acute myocardial injury is common after noncardiac surgery and associated with mortality. Impaired intraoperative cardiovascular dynamics are a risk factor for acute myocardial injury. Optimizing intraoperative cardiovascular dynamics may thus reduce acute myocardial injury. We aimed to investigate the effect of intraoperative personalized goal-directed hemodynamic management on the incidence of acute myocardial injury. We hypothesized that personalized goal-directed hemodynamic management reduces the incidence of acute myocardial injury compared to routine hemodynamic management in high-risk patients having major abdominal surgery. We performed a post-hoc secondary analysis of a randomized clinical trial including 180 high-risk major abdominal surgery patients that were randomized to personalized goal-directed hemodynamic management or routine hemodynamic management. We compared the incidences of acute myocardial injury-defined according to the Fourth Universal Definition of Myocardial Infarction (2018)-between patients randomized to personalized goal-directed hemodynamic management or routine hemodynamic management by calculating the relative and absolute risk reduction together with 95% Wald confidence intervals and P values. Acute myocardial injury occurred in 4 of 90 patients (4%) in the personalized goal-directed hemodynamic management group and in 12 of 90 patients (13%) in the routine hemodynamic management group (relative risk: 0.33, 95% confidence interval: 0.11 to 0.99, P = 0.036; absolute risk reduction: - 9%, 95% confidence interval: - 17% to - 0.68%, P = 0.034). In this post-hoc secondary analysis, intraoperative personalized goal-directed hemodynamic management reduced the incidence of acute myocardial injury compared to routine hemodynamic management in high-risk patients having major abdominal surgery. This needs to be confirmed in larger prospective trials.

AB - Acute myocardial injury is common after noncardiac surgery and associated with mortality. Impaired intraoperative cardiovascular dynamics are a risk factor for acute myocardial injury. Optimizing intraoperative cardiovascular dynamics may thus reduce acute myocardial injury. We aimed to investigate the effect of intraoperative personalized goal-directed hemodynamic management on the incidence of acute myocardial injury. We hypothesized that personalized goal-directed hemodynamic management reduces the incidence of acute myocardial injury compared to routine hemodynamic management in high-risk patients having major abdominal surgery. We performed a post-hoc secondary analysis of a randomized clinical trial including 180 high-risk major abdominal surgery patients that were randomized to personalized goal-directed hemodynamic management or routine hemodynamic management. We compared the incidences of acute myocardial injury-defined according to the Fourth Universal Definition of Myocardial Infarction (2018)-between patients randomized to personalized goal-directed hemodynamic management or routine hemodynamic management by calculating the relative and absolute risk reduction together with 95% Wald confidence intervals and P values. Acute myocardial injury occurred in 4 of 90 patients (4%) in the personalized goal-directed hemodynamic management group and in 12 of 90 patients (13%) in the routine hemodynamic management group (relative risk: 0.33, 95% confidence interval: 0.11 to 0.99, P = 0.036; absolute risk reduction: - 9%, 95% confidence interval: - 17% to - 0.68%, P = 0.034). In this post-hoc secondary analysis, intraoperative personalized goal-directed hemodynamic management reduced the incidence of acute myocardial injury compared to routine hemodynamic management in high-risk patients having major abdominal surgery. This needs to be confirmed in larger prospective trials.

U2 - 10.1007/s10877-022-00826-0

DO - 10.1007/s10877-022-00826-0

M3 - SCORING: Journal article

C2 - 35201549

VL - 36

SP - 1775

EP - 1783

JO - J CLIN MONIT COMPUT

JF - J CLIN MONIT COMPUT

SN - 1387-1307

IS - 6

ER -