Cardiac Monitoring During Surgery May Increase Risk
A new trial suggests that individualized hemodynamic therapy may lead to higher mortality for abdominal surgery patients.
Updated on Oct. 21, 2026 in Heart Disease
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The PELICAN trial found that individualized cardiac index-guided therapy does not improve outcomes for high-risk abdominal surgery patients. In fact, those receiving this specialized monitoring faced a higher risk of death within 90 days compared to those managed with routine care.
Why it matters
This study challenges the standard use of specific hemodynamic monitoring intended to protect organ function during surgery. Surgeons and patients preparing for high-risk abdominal procedures should discuss the risks and benefits of various intraoperative fluid and cardiac management strategies.
In a randomized trial of 1,111 patients with a median age of 67, researchers compared individualized hemodynamic therapy against routine care. While 44.3% of the treatment group experienced the primary outcome compared to 46.9% in the routine group, the study found a notable difference in 90-day mortality.
The players
PELICAN trial
A study conducted across 12 university medical centers in Austria, the Czech Republic, Denmark, Germany, and Spain evaluating hemodynamic management in surgery.
The details
During major abdominal surgery, clinicians often use cardiac index-guided therapy to maintain tissue oxygenation. This involves using preoperative resting cardiac index measurements to guide the administration of intravenous fluids. The goal is to prevent organ injury by ensuring adequate perfusion, yet this trial suggests the intervention may not provide the intended safety benefits.
Timeline
7 days post-operation: Assessment of primary composite outcome.
90 days post-operation: Assessment of patient mortality.
Health Landscape
Intraoperative hemodynamic therapy is a common approach designed to preserve tissue oxygenation during major procedures. This trial challenges existing protocols by demonstrating that an aggressive, individualized approach does not necessarily result in better outcomes than standard care.
If you are scheduled for high-risk abdominal surgery, ask your surgical team what specific hemodynamic monitoring protocols they follow. It is worth discussing with your doctor how these monitoring choices might affect your recovery and overall surgical safety.
The takeaway
Individualized cardiac index-guided therapy failed to improve clinical outcomes for high-risk surgical patients in a recent large-scale trial. Patients should feel empowered to ask their surgical team about the standard protocols they use and how they balance fluid management with patient safety.
Further reading
Learn more about the latest research on Heart Disease and how surgical management impacts long-term health.
Source note: This article includes information reported by Inside Precision Medicine.
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Do you trust that complex medical monitoring techniques always improve recovery outcomes for surgery patients?
