{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T07:33:08Z","timestamp":1764401588096},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,9,4]],"date-time":"2012-09-04T00:00:00Z","timestamp":1346716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Goal\u2010directed therapy has been proposed to improve outcome in high\u2010risk surgery patients. The aim of this study was to investigate whether individualised goal\u2010directed therapy targeting stroke volume and oxygen delivery could reduce the number of patients with post\u2010operative complications and shorten hospital length of stay after open elective lower limb arterial surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty patients scheduled for open elective lower limb arterial surgery were prospectively randomised. The <jats:styled-content style=\"fixed-case\">LiDCO\u2122<\/jats:styled-content><jats:italic>plus<\/jats:italic> system was used for haemodynamic monitoring. In the intervention group, stroke volume index was optimised by administering 250\u2009ml aliquots of colloid intraoperatively and during the first 6\u2009h post\u2010operatively. Following surgery, fluid optimisation was supplemented with dobutamine, if necessary, targeting an oxygen delivery index level \u2265\u2009600\u2009ml\/min<jats:sup>\/<\/jats:sup>m<jats:sup>2<\/jats:sup> in the intervention group. Central haemodynamic data were blinded in control patients. Patients were followed up after 30 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the intervention group, stroke volume index, and cardiac index were higher throughout the treatment period (45\u2009\u00b1\u200910 vs. 41\u2009\u00b1\u200910\u2009ml\/m<jats:sup>2<\/jats:sup>, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009&lt;\u20090.001, and 3.19\u2009\u00b1\u20090.73 vs. 2.77\u2009\u00b1\u20090.76\u2009l\/min<jats:sup>\/<\/jats:sup>m<jats:sup>2<\/jats:sup>, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009&lt;\u20090.001, respectively) as well as post\u2010operative oxygen delivery index (527\u2009\u00b1\u2009120 vs. 431\u2009\u00b1\u2009130\u2009ml\/min<jats:sup>\/<\/jats:sup>m<jats:sup>2<\/jats:sup>, <jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009&lt;\u20090.001). In the same group, 5\/20 patients had one or more complications vs. 11\/20 in the control group (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009=\u20090.05). After adjusting for pre\u2010operative and intraoperative differences, the odds ratio for \u2265\u20091 complications was 0.18 (0.04\u20130.85) in the intervention group (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009=\u20090.03). The median length of hospital stay did not differ between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Perioperative individualised goal\u2010directed therapy may reduce post\u2010operative complications in open elective lower limb arterial surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1399-6576.2012.02755.x","type":"journal-article","created":{"date-parts":[[2012,9,4]],"date-time":"2012-09-04T15:29:34Z","timestamp":1346772574000},"page":"189-198","source":"Crossref","is-referenced-by-count":24,"title":["Haemodynamic optimisation in lower limb arterial surgery: room for improvement?"],"prefix":"10.1111","volume":"57","author":[{"given":"J.","family":"BISGAARD","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Lillebaelt Hospital Kolding  Kolding Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"GILSAA","sequence":"additional","affiliation":[{"name":"Department of 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