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Personalized Versus Protocolized Fluid Management Using Noninvasive Hemodynamic Monitoring (Clearsight System) in Patients Undergoing Moderate-Risk Abdominal Surgery

Joosten, Alexandre MD*; Raj Lawrence, Shalini MD*; Colesnicenco, Alexandra MD*; Coeckelenbergh, Sean MD*; Vincent, Jean Louis MD, PhD; Van der Linden, Philippe MD, PhD; Cannesson, Maxime MD, PhD§; Rinehart, Joseph MD

doi: 10.1213/ANE.0000000000003553
Perioperative Medicine

Advances in noninvasive hemodynamic monitoring systems allow delivery of goal-directed fluid therapy and could therefore be used in less-invasive surgical procedures. In this randomized controlled trial, we compared closed-loop–assisted goal-directed fluid therapy using a noninvasive cardiac output (Clearsight system) monitor (personalized approach) to a protocolized fluid therapy approach in 40 patients undergoing moderate-risk laparoscopic abdominal surgery. Cardiac output and stroke volume variations were not significantly different in both groups and remained within predefined target values >90% of the study time. Personalized fluid therapy does not seem to offer any hemodynamic advantage over a protocolized approach in this population.

From the *Department of Anesthesiology, Cliniques Universitaires de Bruxelles (CUB) Erasme, Université Libre de Bruxelles, Brussels, Belgium

Department of Intensive Care, CUB Erasme, Université Libre de Bruxelles, Brussels, Belgium

Department of Anesthesiology, Centre Hospitalo-Universitaire (CHU) Brugmann, Université Libre de Bruxelles, Brussels, Belgium

§Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California

Department of Anesthesiology and Perioperative Care, University of California Irvine, Orange, California.

Published ahead of print 8 May 2018.

Accepted for publication May 8, 2018.

Funding: Departmental.

Conflicts of Interest: See Disclosures at the end of the article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website.

Trial Registry number: (NCT03039946).

Reprints will not be available from the authors.

Address correspondence to Alexandre Joosten, MD, Department of Anesthesiology, Hospital Erasme, 808 Rt de Lennik, 1070 Brussels, Belgium. Address e-mail to or

Copyright © 2018 International Anesthesia Research Society
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