LiDCO : Further clinical support for LiDCO products

30 July 2014

New nurse-led study shows the benefits of haemodynamic optimisation using LiDCOplus

LiDCO Group Plc (AIM: LID), the cardiovascular monitoring company, announces that a new prospective observational trial covering a total of 264 cardiac surgery patients has been accepted for publication in the next edition of the Journal of Critical Care*. The study showed that the use of LiDCOplus significantly reduced the incidence of acute kidney injury (AKI), reduced the subsequent need for renal replacement therapy, and reduced the hospital length of stay.

Details of the study

The active treatment arm had post-operative stroke volume maximisation using the LiDCOplus which was compared to a treatment arm using standard of care.

The study evaluated the outcome of 123 cardiac surgery patients who had post-operative stroke volume maximisation Goal-Directed Therapy (GDT) using the LiDCOplus compared to 141 patients who had standard post-operative monitoring. The patients all had coronary artery bypass with or without aortic valve surgery. Importantly the intervention was nurse led in the cardiac intensive care unit (ICU) and consisted of fluid challenges to maximise stroke volume over an 8 hour period following admission to the ICU.

Although both groups received similar volumes of fluid, the authors agreed that the GDT group received the fluids earlier before haemodynamic compromise was observed in contrast to the control group who received fluids after signs of haemodynamic compromise. Importantly the incidence of AKI was significantly reduced in the GDT group with a total of 8 patients (6.5%) exhibiting AKI compared to 28 (19.9%) in the standard of care group. The median duration of hospital stay was 6 days in the GDT group compared to 7 days patients receiving standard of care.

The investigators also report that the GDT group had a low (3.3%) requirement for renal replacement therapy (RRT dialysis) compared to 10.6% in the standard of care group. In addition, the rate of readmissions to the ICU was reduced in the GDT group.

Commenting, Terry O'Brien, Chief Executive Officer of LiDCO, said: "This is an important study in a cardiac group of patients where the incidence of AKI is high averaging around 24%. AKI is associated with a high mortality rate of 7% - so avoiding it is very worthwhile clinically. Financially, the number of inpatients affected by AKI means that it has a major impact on healthcare resources. NICE (National Institute for Health and Care Excellence) has estimated that the costs to the NHS of AKI (excluding costs in the community) are between £434m and £620m per year, which is more than the costs associated with breast cancer, or lung and skin cancer combined*. The study clearly shows that avoidance of kidney compromise through using the LiDCO's fluid monitoring technology overseen by the ICU nursing team can reduce the incidence of post-operative AKI by 70%, which represents a significant saving to the NHS and improves patient outcomes."

• Thomson Rebekah, Meeran Hanif, Valencia Oswaldo, Al-Subaie Nawaf, Goal-Directed therapy following cardiac surgery and the incidence of acute kidney injury, Journal of Critical Care (2014), doi: 10.1016/j.jcrc.2014.06.011
• NICE Guidance CG169 Aug 2013: http://www.nice.org.uk/guidance/CG169/chapter/introduction

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