{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T22:16:03Z","timestamp":1789856163415,"version":"4.0.1"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,10]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n The authors hypothesized that goal-directed hemodynamic therapy, based on the combination of functional and volumetric hemodynamic parameters, improves outcome in patients with cardiac surgery. Therefore, a therapy guided by stroke volume variation, individually optimized global end-diastolic volume index, cardiac index, and mean arterial pressure was compared with an algorithm based on mean arterial pressure and central venous pressure.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This prospective, controlled, parallel-arm, open-label trial randomized 100 coronary artery bypass grafting and\/or aortic valve replacement patients to a study group (SG; n = 50) or a control group (CG; n = 50). In the SG, hemodynamic therapy was guided by stroke volume variation, optimized global end-diastolic volume index, mean arterial pressure, and cardiac index. Optimized global end-diastolic volume index was defined before and after weaning from cardiopulmonary bypass and at intensive care unit (ICU) admission. Mean arterial pressure and central venous pressure served as hemodynamic goals in the CG. Therapy was started immediately after induction of anesthesia and continued until ICU discharge criteria, serving as primary outcome parameter, were fulfilled.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Intraoperative need for norepinephrine was decreased in the SG with a mean (\u00b1SD) of 9.0 \u00b1 7.6 versus<\/jats:italic> 14.9 \u00b1 11.1 \u00b5g\/kg (P<\/jats:italic> = 0.002). Postoperative complications (SG, 40 vs.<\/jats:italic> CG, 63; P<\/jats:italic> = 0.004), time to reach ICU discharge criteria (SG, 15 \u00b1 6 h; CG, 24 \u00b1 29 h; P<\/jats:italic> < 0.001), and length of ICU stay (SG, 42 \u00b1 19 h; CG, 62 \u00b1 58 h; P<\/jats:italic> = 0.018) were reduced in the SG.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Early goal-directed hemodynamic therapy based on cardiac index, stroke volume variation, and optimized global end-diastolic volume index reduces complications and length of ICU stay after cardiac surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/aln.0b013e31829bd770","type":"journal-article","created":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T12:12:45Z","timestamp":1370088765000},"page":"824-836","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":161,"title":["Individually Optimized Hemodynamic Therapy Reduces Complications and Length of Stay in the Intensive Care Unit"],"prefix":"10.1097","volume":"119","author":[{"given":"Matthias S.","family":"Goepfert","sequence":"first","affiliation":[{"name":"Senior Physician Anesthesiologist"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Peter","family":"Richter","sequence":"additional","affiliation":[{"name":"Anesthesiologist"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"zu Eulenburg","sequence":"additional","affiliation":[{"name":"Statistician, Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janna","family":"Gruetzmacher","sequence":"additional","affiliation":[{"name":"Resident"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Rafflenbeul","sequence":"additional","affiliation":[{"name":"Resident"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Roeher","sequence":"additional","affiliation":[{"name":"Senior Physician Anesthesiologist"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"von Sandersleben","sequence":"additional","affiliation":[{"name":"Senior Physician Anesthesiologist"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Diedrichs","sequence":"additional","affiliation":[{"name":"Anesthesiologist"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herrmann","family":"Reichenspurner","sequence":"additional","affiliation":[{"name":"Professor of Cardiac Surgery, Director, Department of Cardiovascular Surgery, University Heart Center, University Medical Center Hamburg-Eppendorf."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alwin E.","family":"Goetz","sequence":"additional","affiliation":[{"name":"Professor of Anesthesiology, Director"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Reuter","sequence":"additional","affiliation":[{"name":"Professor of Anesthesiology, Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250219","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1378\/chest.94.6.1176","article-title":"Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients.","volume":"94","year":"1988","journal-title":"Chest"},{"key":"R2-20250219","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1056\/NEJM199510193331601","article-title":"A trial of goal-oriented hemodynamic therapy in critically ill patients. 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