Individualized Cardiac Index-Guided Therapy Fails to Improve Outcomes After Major Abdominal Surgery
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The PELICAN trial, a multicenter, single-blind randomized controlled study published in JAMA, tested whether individualized cardiac index-guided hemodynamic therapy improves outcomes in high-risk patients undergoing elective major abdominal surgery. The trial enrolled 1095 patients and compared the guided approach with routine care. Its primary endpoint was a composite of acute kidney injury, myocardial injury, severe infection, nonfatal cardiac arrest, or death within 7 days. The intervention showed no benefit: the composite outcome occurred in 44.3% of the guided-therapy group versus 46.9% of the routine-care group, a difference that was not statistically significant (RR 0.94, 95.1% CI 0.83-1.08, P=0.38). The result challenges the use of cardiac index-guided hemodynamic optimization in this surgical population.
Written by a model from the reports · updated 4 hours ago
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- JAMAPickIndividualized Cardiac Index-Guided Hemodynamic Therapy in High-Risk Patients Undergoing Elective Major Abdominal Surgery: The PELICAN Randomized Clinical Trial.
The multicenter, single-blind randomized PELICAN trial enrolled 1095 high-risk patients undergoing elective major abdominal surgery and compared individualized cardiac index-guided hemodynamic therapy with routine care. The primary composite endpoint (acute kidney injury, myocardial injury, severe infection, nonfatal cardiac arrest, or death within 7 days) did not differ significantly between groups (44.3% vs 46.9%; RR 0.94, 95.1% CI 0.83-1.08; P = .38).
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