{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:19:25Z","timestamp":1788229165398,"version":"build-2803163510"},"reference-count":12,"publisher":"AACN Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Goal-directed therapy allows clinicians to optimize perfusion and volume status in patients postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effect of a machine learning algorithm to guide postoperative goal-directed fluid therapy in cardiac surgery patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A goal-directed fluid therapy program was implemented in a single center for coronary artery bypass patients with ejection fraction greater than or equal to 45% (implementation period: May 15, 2023, to May 31, 2024). Patient outcomes were compared with outcomes in matched historical control patients (control period: January 3 to October 31, 2022). The primary outcome was acute kidney injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 479 eligible patients were evaluated (246 in the control group and 233 in the goal-directed therapy group). The incidence of acute kidney injury on postoperative day 2 (P = .01), on postoperative day 7(P = .02), and at discharge (P = .008) was lower in the goaldirected therapy group than in the control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients in the goal-directed therapy program had a lower incidence of acute kidney injury compared with historical control patients. Incorporating a machine learning algorithm to guide goal-directed fluid therapy was a safe and less invasive way to monitor selected patients in the intensive care unit after cardiac surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ajcc2026587","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:02:52Z","timestamp":1788228172000},"page":"378-383","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a Machine Learning Algorithm to Guide Goal-Directed Therapy After Cardiac Surgery"],"prefix":"10.4037","volume":"35","author":[{"given":"Amanda","family":"Rea","sequence":"first","affiliation":[{"name":"Amanda Rea is lead of advanced practice, clinical program manager, Division of Cardiac Surgery, University of Maryland St Joseph Medical Center, Towson, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Deasel","sequence":"additional","affiliation":[{"name":"Alexandra Deasel is a Society of Thoracic Surgery outcomes coordinator, Division of Cardiac Surgery, University of Maryland St Joseph Medical Center, Towson, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford Edwin","family":"Fonner","sequence":"additional","affiliation":[{"name":"Clifford Edwin Fonner is a director of analytics, Maryland Cardiac Surgery Quality Initiative (MCSQI)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawn","family":"Salenger","sequence":"additional","affiliation":[{"name":"Rawn Salenger is a clinical associate professor, Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, and a chief, Division of Cardiac Surgery, University of Maryland St Joseph Medical Center, Towson."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"8","key":"2026083122022995800_b1-0350378","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1001\/jamasurg.2019.1153","article-title":"Guidelines for perioperative care in cardiac surgery: Enhanced Recovery After Surgery Society recommendations","volume":"154","author":"Engelman","year":"2019","journal-title":"JAMA Surg"},{"issue":"4","key":"2026083122022995800_b2-0350378","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1016\/j.athoracsur.2023.12.006","article-title":"Perioperative care in cardiac surgery: a joint consensus statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and the Society of Thoracic Surgeons (STS)","volume":"117","author":"Grant","year":"2024","journal-title":"Ann Thorac Surg"},{"issue":"6","key":"2026083122022995800_b3-0350378","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1016\/j.athoracsur.2021.06.072","article-title":"Cardiac Enhanced Recovery After Surgery: early outcomes in a community setting","volume":"113","author":"Salenger","year":"2022","journal-title":"Ann Thorac Surg"},{"issue":"5","key":"2026083122022995800_b4-0350378","doi-asserted-by":"publisher","first-page":"1868","DOI":"10.1016\/j.jtcvs.2019.03.135","article-title":"Goal-directed resuscitation following cardiac surgery reduces acute kidney injury: a quality initiative pre-post analysis","volume":"159","author":"Johnston","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"4","key":"2026083122022995800_b5-0350378","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1093\/bja\/aet020","article-title":"Goal-directed therapy in cardiac surgery: a systematic review and metaanalysis","volume":"110","author":"Aya","year":"2013","journal-title":"Br J Anaesth"},{"key":"2026083122022995800_b6-0350378","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1016\/j.xjon.2023.06.023","article-title":"Advanced artificial intelligence-guided hemodynamic management within cardiac enhanced recovery after surgery pathways: a multiinstitution review","volume":"16","author":"Reddy","year":"2023","journal-title":"JTCVS Open"},{"issue":"7","key":"2026083122022995800_b7-0350378","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1097\/EJA.0000000000000778","article-title":"Does goaldirected haemodynamic and fluid therapy improve perioperative outcomes? 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