25580087
BACKGROUND	Tissue hypoperfusion occurs frequently during surgery and may contribute to postoperative organ dysfunction .
BACKGROUND	There is a need for perioperative treatment protocols aiming at improving tissue oxygenation ( StO2 ) .
BACKGROUND	We hypothesised that intra-operative optimisation of StO2 improves tissue perfusion and thus reduces postoperative complications .
BACKGROUND	Furthermore , we evaluated the feasibility of the optimisation algorithm used .
METHODS	We randomized 50 high-risk patients , all > 65 years with ASA physical status III , who underwent major abdominal surgery under standardized balanced general anesthesia combined with epidural analgesia .
METHODS	Throughout surgery StO2 was monitored at the thenar eminence using near-infrared spectroscopy .
METHODS	All patients were treated according to a standard care algorithm .
METHODS	In addition , patients in the intervention group were treated with dobutamine if necessary to keep or raise StO280 % .
METHODS	Data were recorded continuously and complications were recorded during hospital stay with a maximum of 28 days .
RESULTS	The number of complications was not significantly different between groups ( 11 vs 20 ; p = 0.23 ) .
RESULTS	Eleven patients in the intervention group had no complication , versus 7 in the control group .
RESULTS	There was no significant difference between groups in length of stay in ICU or in hospital .
RESULTS	Only ten patients in the intervention group received dobutamine .
RESULTS	Administration of dobutamine resulted in a moderate 6 [ -3 to 10 ] % increase of StO2 .
RESULTS	The overall protocol adherence was 94 % .
CONCLUSIONS	No statistically significant difference in outcome was realized through intraoperative optimization of StO2 values in this pilot study .
CONCLUSIONS	The protocol used may be considered feasible for clinical practice .
CONCLUSIONS	Further research is obligatory to define both the optimal StO2 threshold and intervention to treat tissue hypoperfusion .
BACKGROUND	ClinicalTrials.gov identifier : NCT01342900 .
BACKGROUND	Registered 21 April 2011 .

