Individualized Cardiac Index-Guided Hemodynamic Therapy in High-Risk Patients Undergoing Elective Major Abdominal Surgery: The PELICAN Randomized Clinical Trial.

Individualized cardiac index-guided hemodynamic therapy does not significantly reduce the composite postoperative complications in high-risk abdominal surgery patients compared to routine therapy.

• Why it matters: Determining whether tailored intraoperative hemodynamic management improves outcomes remains important for optimizing care in high-risk surgical patients.
• What they did: The trial randomized 1111 high-risk patients undergoing elective major abdominal surgery to either individualized cardiac index-guided therapy or routine therapy, measuring the occurrence of major postoperative complications within 7 days.
• The result: The primary outcome occurred in 44.3% of the individualized therapy group versus 46.9% in the routine group, with no significant difference (relative risk 0.94, P=0.38), indicating no benefit of the tailored approach.