Major general surgery Surgery
Conditions
Interventions
Goal directed therapy protocol to achieve oxygen delivery index of 600 ml/min/m^2 compared to protocol designed to reflect standard care.
Sponsors
St Georges Hospital (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patients aged 18 years or older presenting for major surgery expected to last more than one and a half hours were eligible for inclusion if one or more of the following criteria were satisfied before surgery: 1. Severe cardiac or respiratory illness resulting in severe functional limitation 2. Extensive surgery planned for carcinoma involving bowel anastamosis 3. Acute massive blood loss (greater than 2.5 l) 4. Aged over 70 years with moderate functional limitation of one or more organ systems 5. Septicaemia (positive blood cultures or septic focus) 6. Respiratory failure (partial pressure of oxygen in arterial blood [PaO2] less than 8 kPa on Fraction of inspired Oxygen [FiO2] greater than 0.4, i.e., PaO2 : FiO2 ratio less than 20 kPa or ventilation greater than 48 hours) 7. Acute abdominal catastrophe (e.g., pancreatitis, perforated viscous, gastro-intestinal bleed) 8. Acute renal failure (urea greater than or equal to 20 mmol/l, creatinine greater than 60 µmol/l) 9. Surgery for abdominal aortic aneurysm
Exclusion criteria
Exclusion criteria: 1. Refusal of consent 2. Pregnancy 3. Acute myocardial ischaemia prior to enrolment 4. Patients receiving palliative treatment only 5. Disseminated malignancy 6. Patients unlikely to survive more than 6 hours 7. Patients requiring intervention outside intensive care unit (ICU) within the first 6 hours following surgery 8. Patients on lithium therapy 9. Weight less than 40 kg
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| Mortality and duration of hospital stay. | — |
Primary
| Measure | Time frame |
|---|---|
| Incidence of post-operative complications. | — |
Countries
United Kingdom
Outcome results
None listed