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Comment & Response
October 8, 2014

Use of Hemodynamic Algorithm After Gastrointestinal Surgery

Author Affiliations
  • 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA. 2014;312(14):1470. doi:10.1001/jama.2014.10360

To the Editor The main result of the OPTIMISE randomized clinical trial was that goal-directed therapy using fluids and inotropes to achieve noninvasive cardiac output goals did not significantly alter any of the primary or secondary morbidity or mortality end points.1

Dr Pearse and colleagues1 also performed a systematic review and meta-analysis, combining their data along with data from a few small trials with the results of a recent Cochrane review,2 and reported that complications after surgery were significantly reduced by goal-directed therapy. Based on the updated meta-analysis, the authors of the OPTIMISE study and accompanying editorialist3 concluded that goal-directed therapy is an effective strategy to decrease perioperative complication rates.

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