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Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery

Grocott, Michael P.W., Dushianthan, Ahilanandan, Hamilton, Mark A., Mythen, Michael G., Harrison, David and Rowan, Kathy (2012) Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery Cochrane Database of Systematic Reviews, 11, CD004082. (doi:10.1002/14651858.CD004082.pub5). (PMID:23152223).

Record type: Article

Abstract

It remains uncertain whether increasing blood flow using fluids, with or without inotropes or vasoactive drugs, reduces mortality in adults undergoing surgery. The primary analysis in this review (mortality at longest follow-up) showed no difference between the intervention and control, but this result was sensitive to the method of analysis, the withdrawal of studies with methodological limitations, and is dominated by a single large RCT. Overall, for every 100 patients in whom blood flow is increased perioperatively to defined goals, one can expect 13 in 100 patients (from 40/100 to 27/100) to avoid a complication, 2/100 to avoid renal impairment (from 8/100 to 6/100), 5/100 to avoid respiratory failure (from 10/100 to 5/100), and 4/100 to avoid postoperative wound infection (from 10/100 to 6/100). On average, patients receiving the intervention stay in hospital one day less. It is unlikely that the intervention causes harm. The balance of current evidence does not support widespread implementation of this approach to reduce mortality but does suggest that complications and duration of hospital stay are reduced.

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Published date: 14 November 2012

Identifiers

Local EPrints ID: 347545
URI: http://eprints.soton.ac.uk/id/eprint/347545
ISSN: 1469-493X
PURE UUID: 644a8396-8a36-47bd-b1cf-fffff1a21c83

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Date deposited: 24 Jan 2013 09:52
Last modified: 18 Jul 2017 04:57

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Contributors

Author: Ahilanandan Dushianthan
Author: Mark A. Hamilton
Author: Michael G. Mythen
Author: David Harrison
Author: Kathy Rowan

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