LiDCO Group Plc welcomes a study published in the British Journal of Surgery, in which its LiDCO rapid haemodynamic monitor was used as part of a standardised clinical pathway to optimise patients, which has shown a significant improvement in patient outcomes.
In particular, patients treated on the clinical pathway showed a significant reduction in length of hospital stay (by an average of ten days), immediate extubation and first-day mobilisation following surgery.
Dr Terry O’Brien, CEO of LiDCO, commented: “Resources are being squeezed and healthcare systems are increasingly required to optimise their practice. I am delighted with the very significant results obtained in this study. The investigators used the LiDCOrapid monitor in this oesophagectomy clinical pathway for the fluid and drug management of patients undergoing a very demanding surgery, and materially improved patient outcomes.
LiDCO’s ease of use facilitates the adoption of improvements in hospital processes that are increasingly shown to lead to better short-term outcomes. With its additional non-invasive functionality, the LiDCOrapid v2 with Unity software will be available shortly, further expanding the numbers of patients who can benefit.”
Details of the study
The study took the standardised oesophagectomy clinical pathway (“SOCP”) developed at the Department of Thoracic Surgery at Virginia Mason Medical Centre (“VMMC”) in the US, and applied a similar pathway to patients undergoing oesophagectomy at the Royal Surrey County Hospital (“RSCH”) in Guildford, UK. The objective was to see whether a SOCP could be transferred between hospitals to improve patient outcomes. Goal-directed fluid therapy using the LiDCOrapid intra operatively and for six hours post surgery was applied to all patients under the standardised care pathway at RSCH. Intraoperative fluid management is an established standard of care at RSCH.
Patients were grouped based on whether or not they were operated on under the SOCP (group 3 and group 1 respectively) and were compared with each other as well as compared with a US group who had been operated under the SOCP at VMMC (group 4). Patients in group 2 were operated on after the introduction of the SOCP but were not included in the pathway.
Fewer patients experienced postoperative complications following introduction of the clinical pathway (9 of 12 in group 1, versus 4 of 12 in group 3; P = < 0.041). Statistical analysis indicated that the SOCP was the only variable significantly associated with a reduced incidence of postoperative complications.
Significant improvements seen following implementation of the clinical pathway included the proportion of patients mobilising on postoperative day 1 (1 of 12 in group 1 versus 12 of 12 in group 3; P < 0.001), median length of critical care stay (4 (range 2–20) versus 3 (1–5) days respectively; P < 0.001) and median length of hospital stay (17 (12–30) versus 7 (6–37) days; P = 0.022). Statistical analysis confirmed the SOCP to be the only variable significantly associated with a reduced length of hospital stay.
