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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 https://doi.org/10.1186/1471-2261-7-10
SGUL Authors: Rhodes, Andrew

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Abstract

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 (http://creativecommons.org/licenses/by/2.0), 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
Dates:
DateEvent
19 March 2007Published
19 March 2007Accepted
Publisher License: Creative Commons: Attribution 2.0
PubMed ID: 17371601
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/110401
Publisher's version: https://doi.org/10.1186/1471-2261-7-10

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