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Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management  Data Analysis
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Doppler Guided Intraoperative Fluid Management Data Analysis

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  • 1. 1 DOPPLER GUIDED INTRAOPERATIVE FLUID MANAGEMENT: DATA ANALYSIS NHS Technology Adoption Centre, January 2010.
  • 2. Intervention vs. Comparator 2 Intervention (n = 626) London: 1st April 2008 – 30th April 2009; Manchester: 1st January 2009 – 30th November 2009; Derby: 19th September 2008 – 30th November 2009. Control (n = 621) London: 1st March 2007 – 31st March 2008; Manchester: 1st January 2008 – 30th December 2008; Derby: 1st March 2007 – 18th September 2008.
  • 3. Surgical Procedures 3 Orthopaedics: Joint Replacement. Lower GI: Hartmann’s, Colectomy, Hemicolectomy. Upper GI: Whipples, Gastrostomy. Colorectal: Laparotomy, Bowel and Anterior Resection. Renal and Pancreas Transplants. Urological Cancer: Cystectomy and Nephrectomy.
  • 4. Pre-operative Morbidity Risk 4 Assessment POSSUM: All Patients
  • 5. 67% Decrease in Operative Mortality Rate 5
  • 6. Intra-operative fluids administered: All 6 Patients
  • 7. Length of Stay: All Patients 7
  • 8. Post-operative Length of Stay: All 8 Patients
  • 9. 23% Decrease in Central Venous 9 Catheter Insertion Rates
  • 10. 33% Decrease in Re-admission Rate 10
  • 11. 25% Decrease in Re-operation Rate 11
  • 12. Critical Care Admission 12
  • 13. Critical Care Length of Stay 13 Level 1: Mean LOS – Intervention 3.11 Days, Control 2.95 Days. Median LOS – Intervention 3 Days, Control 3 Days. Level 2: Mean LOS – Intervention 4.58 Days, Control 4.73 Days. Median LOS – Intervention 3 Days, Control 3 Days. Level 3: Mean LOS – Intervention 8.40 Days, Control 19.31 Days. Median LOS – Intervention 6.5 Days, Control 11 Days.
  • 14. Critical Care LOS: Level 1 14
  • 15. Critical Care LOS: Level 2 15
  • 16. Critical Care LOS: Level 3 16
  • 17. Statistical significance 17 POSSUM score - Independent t-test Two-sided P = 0.020; Significant differences in POSSUM scores between the two groups. LOS and Post-op LOS - Independent t-test Two-sided P = 0.001 and P = 0.000 respectively; Significant differences in LOS and post-op LOS between the two groups. Note: If the p-value is <=0.05 the factor of interest is statistically different between the intervention and control (i.e. significant).
  • 18. Statistical significance 18 CVC insertion - Independent t-test Two-sided P = 0.000; Significant differences in CVC insertion rate between the two groups. Re-admission and Re-operative rates – Independent t-test Two sided P = 0.286 and P = 0.212 respectively; No significant differences in re-admission and re-operative rates between the two groups.
  • 19. Statistical significance 19 Mortality rate – Independent t-test Two-sided P = 0.001; Significant differences in mortality rates between the two groups. LOS in critical care levels 1,2 & 3 – Mann-Whitney test P = 0.265, P = 0.775 and P = 0.277 respectively; No significance differences observed in the length of stay for critical care levels 1,2 & 3 between the two groups.
  • 20. Results Summary 20 67% Decrease in Mortality Three Day Reduction in Length of Stay Four Day Reduction in Post-op LOS 23% Decrease in CVC Insertion Rate 33% Decrease in Re-admission Rate 25% Decrease in Re-operation Rate Eleven Day Reduction in LOS within Critical Care Level Three

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