caa a22 4500 605510032 CHVBK 20210128100644.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10877-014-9611-5 doi (NATIONALLICENCE)springer-10.1007/s10877-014-9611-5 Early goal-directed therapy based on endotracheal bioimpedance cardiography: a prospective, randomized controlled study in coronary surgery [Elektronische Daten] [Jean-Luc Fellahi, David Brossier, Fabien Dechanet, Marc-Olivier Fischer, Vladimir Saplacan, Jean-Louis Gérard, Jean-Luc Hanouz] The objective was to compare the impact of an early goal-directed hemodynamic therapy based on cardiac output monitoring (Endotracheal Cardiac Output Monitor, ECOM) with a standard of care on postoperative outcome following coronary surgery. This prospective, controlled, parallel-arm trial randomized 100 elective primary coronary artery bypass grafting patients to a study group (ECOM; n=50) or a control group (control; n=50). In the ECOM group, hemodynamic therapy was guided by respiratory stroke volume variation and cardiac index given by the ECOM system. A standard of care was used in the control. Goal-directed therapy was started immediately after induction of anesthesia and continued until arrival in the intensive care unit (ICU). The primary endpoint was the time when patients fulfilled discharge criteria from hospital (possible hospital discharge). Secondary endpoints were the hospital discharge, the time to reach extubation, the length of stay in ICU, the number of major adverse cardiac events, and in-hospital mortality. Patients in the ECOM group received more often fluid loading and dobutamine. The time to reach extubation was reduced in the ECOM group: 510min [360-1,110] versus 570min [320-1,520], P=0.005. No significant differences were found between both groups for possible hospital discharge [Hazard Ratio=0.96 (95%CI0.64-1.45)] and hospital discharge [Hazard Ratio=1.20 (95% CI0.79-1.81)]. A mini-invasive early goal-directed hemodynamic therapy based on ECOM can reduce the time to reach extubation but fails to significantly reduce the length of stay in hospital and the rate of major cardiac morbidity. Springer Science+Business Media New York, 2014 Mini-invasive cardiac output monitoring nationallicence Endotracheal Cardiac Output Monitor nationallicence Goal-directed hemodynamic therapy nationallicence Coronary surgery nationallicence Fellahi Jean-Luc Department of Anesthesiology and Critical Care Medicine, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Hospices Civils de Lyon, 28 avenue du Doyen Lépine, 69677, Lyon-Bron Cedex, France aut Brossier David Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut Dechanet Fabien Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut Fischer Marc-Olivier Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut Saplacan Vladimir Department of Cardiothoracic Surgery, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut Gérard Jean-Louis Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut Hanouz Jean-Luc Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/3(2015-06-01), 351-358 1387-1307 29:3<351 2015 29 10877 https://doi.org/10.1007/s10877-014-9611-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9611-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fellahi Jean-Luc Department of Anesthesiology and Critical Care Medicine, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Hospices Civils de Lyon, 28 avenue du Doyen Lépine, 69677, Lyon-Bron Cedex, France aut NATIONALLICENCE 700 1- Brossier David Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut NATIONALLICENCE 700 1- Dechanet Fabien Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut NATIONALLICENCE 700 1- Fischer Marc-Olivier Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut NATIONALLICENCE 700 1- Saplacan Vladimir Department of Cardiothoracic Surgery, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut NATIONALLICENCE 700 1- Gérard Jean-Louis Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut NATIONALLICENCE 700 1- Hanouz Jean-Luc Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Avenue de la Côte de Nacre, 14000, Caen, France aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/3(2015-06-01), 351-358 1387-1307 29:3<351 2015 29 10877