The incidence of myocardial injury following post-operative Goal Directed Therapy

Studies suggest that Goal Directed Therapy (GDT) results in improved outcome following major surgery. However, there is concern that pre-emptive use of inotropic therapy may lead to an increased incidence of myocardial ischaemia and infarction. Post hoc analysis of data collected prospectively durin...

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Veröffentlicht in:BMC cardiovascular disorders 2007-03, Vol.7 (1), p.10-10, Article 10
Hauptverfasser: Pearse, Rupert M, Dawson, Deborah, Fawcett, Jayne, Rhodes, Andrew, Grounds, R Michael, Bennett, David
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Sprache:eng
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Zusammenfassung:Studies suggest that Goal Directed Therapy (GDT) results in improved outcome following major surgery. However, there is concern that pre-emptive use of inotropic therapy may lead to an increased incidence of myocardial ischaemia and infarction. Post hoc analysis of data collected prospectively during a randomised controlled trial of the effects of post-operative GDT in high-risk general surgical patients. Serum troponin T concentrations were measured at baseline and on day 1 and day 2 following surgery. Continuous ECG monitoring was performed during the eight hour intervention period. Patients were followed up for predefined cardiac complications. A univariate analysis was performed to identify any associations between potential risk factors for myocardial injury and elevated troponin T concentrations. GDT was associated with fewer complications, and a reduced duration of hospital stay. Troponin T concentrations above 0.01 microg l-1 were identified in eight patients in the GDT group and six in the control group. Values increased above 0.05 microg l-1 in four patients in the GDT group and two patients in the control group. There were no overall differences in the incidence of elevated troponin T concentrations. The incidence of cardiovascular complications was also similar. None of the patients, in whom troponin T concentrations were elevated, developed ECG changes indicating myocardial ischaemia during the intervention period. The only factor to be associated with elevated troponin T concentrations following surgery was end-stage renal failure. The use of post-operative GDT does not result in an increased incidence of myocardial injury.
ISSN:1471-2261
1471-2261
DOI:10.1186/1471-2261-7-10