JAMA

🚨Excited to share our PELICAN Randomized Clinical Trial, just published in JAMA (D1, IF 65.4) 📄 Individualized Cardiac Index-Guided Hemodynamic Therapy in High-Risk Patients Undergoing Elective Major Abdominal Surgery: The PELICAN Randomized Clinical Trial 🌍 A large, international, multicenter RCT conducted across 12 university hospitals in Austria, the Czech Republic, Denmark, Germany, and Spain. 🔬 The clinical question: Does individualized intraoperative hemodynamic therapy targeting each patient’s preoperative resting cardiac index improve postoperative outcomes compared with routine hemodynamic management? 👥 1,095 patients included in the primary analysis. 📊 Key findings: Major postoperative complications occurred in 44.3% of patients receiving individualized cardiac index-guided therapy versus 46.9% receiving routine care. Relative risk: 0.94 (95.1% CI, 0.83–1.08; P=.38). No significant differences were observed in acute kidney injury, myocardial injury, severe infectious complications, cardiac arrest, or mortality within 7 postoperative days. 💡 Clinical implications: Despite the physiological rationale for individualized hemodynamic optimization, targeting the patient’s preoperative resting cardiac index did not significantly reduce major postoperative complications. These findings challenge the assumption that more individualized hemodynamic targets necessarily translate into better clinical outcomes and provide important evidence to inform perioperative hemodynamic management. 🤝 Grateful to all investigators, participating centers, and collaborators for their outstanding contribution to this international research effort. Publishing this work in JAMA, one of the world’s leading medical journals, represents an important milestone for our collaborative research. acrobat.adobe.com/id/urn:aai… #JAMA #PELICANTrial #Anesthesiology #PerioperativeMedicine #Hemodynamics @sedar_es @SCISEDAR @MontesinosSanti @mjcolomina @DrFDamico @JG_Anestesia @FernandoRamasco @bio_critic @BadenesR @MarinaVarelaDu1 @giovannilandoni @germ_red @ClinicaNavarra @JAMA_current