A randomised trial of non-invasive cardiac output monitoring to guide haemodynamic optimisation in high risk patients undergoing urgent surgical repair of proximal femoral fractures (ClearNOF trial NCT02382185)

• DOI: 10.1186/s13741-019-0119-x
• Publication Date: 2019-08-07T23:02:39Z
• Authors: S. J. Davies; D. R. Yates; R. J. T. Wilson; Z. Murphy; A. Gibson; V. Allgar; T. Collyer
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Femoral neck fracture; RD1-811; Research; Surgery; Hemodynamic; Cardiac Output; 3. Good health

Hip fracture is a procedure with high mortality and complication rates, there exists group especially at risk of these outcomes identified by their Nottingham Fracture Score (NHFS). Meta-analysis suggests possible benefit to this patient from intravascular volume optimisation. We investigated whether intraoperative fluid blood pressure optimisation improved complications in group. Patients NHFS ≥ 5 were enrolled into multicentre observer-blinded randomised control trial. allocated either standard care or combination using non-invasive system. The primary outcome was the number patients one more each Secondary included hospital length stay (LOS), incidence hypotension vasopressor usage. Forty-six percent intervention suffered compared 51% (OR 0.82 (95% CI 0.49–1.36)). Per-protocol analysis OR 0.73 0.43–1.24). Median LOS same between both groups; however, mean on per-protocol longer (23.2 (18.0) days vs. 18.5 (16.5), p = 0.047). Haemodynamic including management high-risk undergoing repair hip did not result statistically significant reduction complications; potential seen. A trial cardiac output monitoring guide haemodynamic urgent surgical proximal femoral fractures (ClearNOF NCT02382185).