Myocardial Injury and Goal Directed Therapy After Surgery
Author Information
Author(s): Rupert M Pearse, Deborah Dawson, Jayne Fawcett, Andrew Rhodes, Michael Grounds, David Bennett
Primary Institution: Barts and The London School of Medicine and Dentistry, Queen Mary's University of London
Hypothesis
Does post-operative Goal Directed Therapy (GDT) increase the incidence of myocardial injury?
Conclusion
The use of post-operative GDT does not result in an increased incidence of myocardial injury.
Supporting Evidence
- GDT was associated with fewer complications and a reduced duration of hospital stay.
- Troponin T concentrations above 0.01 μg l-1 were identified in eight patients in the GDT group.
- There were no overall differences in the incidence of elevated troponin T concentrations between groups.
- The only factor associated with elevated troponin T concentrations was end-stage renal failure.
Takeaway
This study found that using a special treatment after surgery doesn't hurt the heart more than regular treatment.
Methodology
Post hoc analysis of data from a randomized controlled trial measuring serum troponin T concentrations and monitoring patients for cardiac complications.
Potential Biases
No attempts were made to standardize cardiac medications prior to surgery.
Limitations
This was a post hoc analysis of a small, single center trial not specifically designed to test the association between cardiac risk factors and myocardial injury.
Participant Demographics
Patients undergoing major surgery, with a mix of co-existing diseases and pre-operative cardiac medications.
Statistical Information
P-Value
0.007
Confidence Interval
0.46–0.89
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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