Perioperative non-invasive haemodynamic optimisation using photoplethysmography: A randomised controlled trial and meta-analysis.

Autor: Fischer MO; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France. Electronic address: marcolivierfischer@yahoo.fr., Fiant AL; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Debroczi S; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Boutros M; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Pasqualini L; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Demonchy M; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Flais F; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Alves A; UNICAEN, service de chirurgie digestive, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Gérard JL; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Buléon C; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France., Hanouz JL; UNICAEN, service d'anesthésie réanimation, Normandie université, CHU de Caen Normandie, 14000 Caen, France.
Jazyk: angličtina
Zdroj: Anaesthesia, critical care & pain medicine [Anaesth Crit Care Pain Med] 2020 Jun; Vol. 39 (3), pp. 421-428. Date of Electronic Publication: 2020 Mar 27.
DOI: 10.1016/j.accpm.2020.03.016
Abstrakt: Background: The present study aimed at evaluating the effect of a haemodynamic algorithm using SV maximisation by non-invasive photoplethysmography (interventional group) on the incidence of postoperative complications compared with a control group using intermittent mean arterial pressure.
Methods: The non-blinded parallel-group trial randomised low-risk patients undergoing colorectal surgery into either interventional group or control group. The primary outcome was the incidence of patients with at least one complication during the 30 days following surgery. The secondary outcomes were the total number of complications, the length of hospital stay and postoperative mortality. A meta-analysis of randomised trials comparing perioperative haemodynamic optimisation (interventional group) using photoplethysmography with control group was performed to assess the external validity.
Results: Among 160 randomised patients, 159 were analysed (80 and 79 in interventional and control groups, respectively). Demographic characteristics were similar in both groups. Postoperative complications occurred in 40 (50%) and 34 (43%) patients in the interventional and control groups, respectively (P=0.471). There were no significant differences between the two groups regarding the total number of complications (P=0.078), the hospital length of stay (P=0.960), or postoperative mortality (P=1.000). In the meta-analysis including 1089 patients in 7 randomised controlled studies, 203 (38%) and 221 (40%) patients suffered from at least one complication following surgery [risk ratio 0.89 (95% CI 0.68-1.17), P=0.407] in interventional and control groups, respectively.
Conclusions: Based on the findings of the present study and meta-analysis, a haemodynamic perioperative algorithm using SV maximisation by non-invasive photoplethysmography cannot reduce postoperative morbidity.
(Copyright © 2020 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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