To the Editor The pragmatic, multicenter, randomized, observer-blinded Optimisation of Cardiovascular Management to Improve Surgical Outcome (OPTIMISE) trial1 found that a cardiac output–guided hemodynamic treatment algorithm did not result in a statistically significant improvement in outcomes compared with usual care in high-risk patients undergoing major gastrointestinal surgery. An updated meta-analysis on perioperative goal-directed therapy, which was part of the same article, came to the opposite conclusion.
Saugel B, Reuter DA. Use of Hemodynamic Algorithm After Gastrointestinal Surgery. JAMA. 2014;312(14):1469–1470. doi:10.1001/jama.2014.10363