Perioper Med (Lond). 2015 Jul 22;4:7. doi: 10.1186/s13741-015-0017-9. eCollection 2015.
Perioperative medicine (London, England)
Rupert M Pearse
PMID: 26203354 PMCID: PMC4511256 DOI: 10.1186/s13741-015-0017-9
The use of cardiac output monitoring to guide fluid and inotropic therapy in surgical patients has remained a controversial topic for more than 40 years. The reasons for this are numerous and complex, but key amongst them is the interplay between poor research methodology and the likely selective reporting of randomised trials. In this issue of Perioperative Medicine, we find a very unusual report, one which describes a randomised trial stopped for futility after the recruitment of only a small proportion of the target patient sample (Jammer et al. Periop Med). The authors offer no statistical analysis of their findings but simply an explanation of what went wrong. On the face of it, this exercise would seem to offer little of value to the general reader. How can publication of the findings of an unsuccessful trial contribute to the evidence base on this topic? To understand this, we must delve a little deeper into the evidence and see how these trials were designed.
Keywords: Fluid therapy; Methods; Monitoring; Physiologic; Randomised trials; Surgery
