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Aslam et al. Mini-invasive Surg 2018;2:10 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2017.42

Original Article Open Access

Does intra-operative cardiac output monitoring
improve outcomes for patients undergoing elective
colorectal surgery within an enhanced recovery
programme?

Muhammad Imran Aslam, Harriet Smith, Chelise Currow, Nadia Akhtar, Julia Merchant, Richard Evans,
Ugochukwu Ihedioha, Peter Kang

Department of Colorectal Surgery, Northampton General Hospital, NHS Trust, Cliftonville, Northampton NN1 5BD, UK.
Correspondence to: Mr. Muhammad Imran Aslam, Department of Colorectal Surgery, Northampton General Hospital, NHS
Trust, Cliftonville, Northampton NN1 5BD, UK. E-mail: mia7@le.ac.uk

How to cite this article: Aslam MI, Smith H, Currow C, Akhtar N, Merchant J, Evans R, Ihedioha U, Kang P. Does intra-operative
cardiac output monitoring improve outcomes for patients undergoing elective colorectal surgery within an enhanced recovery
programme? Mini-invasive Surg 2018;2:10. http://dx.doi.org/10.20517/2574-1225.2017.42

Received: 12 Oct 2017 First Decision: 1 Feb 2018 Revised: 7 Apr 2018 Accepted: 18 Apr 2018 Published: 27 Apr 2018

Science Editor: Charles F. Bellows Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Aim: Intra-operative cardiac output (CO) monitoring became a standard of care in Northampton General Hospital, UK,
at the end of 2013. This study aimed to assess the effectiveness of intra-operative CO monitoring with oesophageal
Doppler or LiDCO for patients undergoing elective colorectal surgery for cancer within an enhanced recovery after
surgery (ERAS).

Methods: Data was prospectively collected over a 5-year period (March 2010 - Feb 2015) for patients undergoing
elective colorectal surgery in the practice of a single surgeon. The ERAS protocol was applied for all the patients. There
were 69 patients who had intra-operative CO monitoring with oesophageal Doppler or LiDCO and 144 patients who had
no intra-operative CO monitoring. Results were analysed for post-operative outcomes (morbidity, mortality, readmission
within 30 days, total length of hospital stay and admission to a high level of care facility).

Results: There was no significant difference in 30-day morbidity and readmission rates between the two examined
groups. Forty-six percent of patients in the intra-operative CO monitoring group were admitted to a low level of care
facility (ward) in comparison to 24% of patients in the no intra-operative CO monitoring group (P = 0.01).

Conclusion: Using intra-operative CO monitoring singnificantly might reduce the need for admission to critical care. A
larger cohort study is needed to further confirm these findings and account for any co-founders.

Keywords: Non-invasive cardiac output monitoring, enhanced recovery, colorectal surgery, outcomes, perioperative care

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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