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

Pearse, RM; Dawson, D; Fawcett, J; Rhodes, A; Grounds, RM; Bennett, D (2007) The incidence of myocardial injury following post-operative Goal Directed Therapy. BMC Cardiovasc Disord, 7. p. 10. ISSN 1471-2261
SGUL Authors: Rhodes, Andrew

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BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: The use of post-operative GDT does not result in an increased incidence of myocardial injury.

Item Type: Article
Additional Information: © 2007 Pearse et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Cardiotonic Agents, Electrocardiography, Ambulatory, Follow-Up Studies, Humans, Incidence, Myocardial Infarction, Postoperative Care, Retrospective Studies, Risk Factors, Troponin T, Humans, Myocardial Infarction, Troponin T, Cardiotonic Agents, Electrocardiography, Ambulatory, Postoperative Care, Incidence, Risk Factors, Retrospective Studies, Follow-Up Studies, 1102 Cardiovascular Medicine And Haematology, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cell Sciences (INCCCS)
Journal or Publication Title: BMC Cardiovasc Disord
ISSN: 1471-2261
Language: eng
19 March 2007Published
19 March 2007Accepted
Publisher License: Creative Commons: Attribution 2.0
PubMed ID: 17371601
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