Condition category
Digestive System
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims
Cardiac output is the volume of blood pumped by the heart per minute. It can be measured by placing a probe into the oesophagus (food pipe) via the mouth or nose, a procedure called oesophageal Doppler monitoring. Guiding treatment with cardiac output monitoring has been shown to benefit patients undergoing major colorectal surgery, improving outcomes and reducing the length of hospital stay. Traditionally this monitoring has only been used during surgery. With the introduction of flexible probes, this monitoring can now be used in awake patients after surgery. The group most likely to benefit are high-risk patients. We aim to find out about the effect of continuing the use of this monitoring to guide treatment after surgery in high-risk colorectal surgery patients.

Who can participate?
High-risk patients aged 18 and over undergoing colorectal surgery.

What does the study involve?
Participants are randomly allocated to one of two groups. Participants in one group undergo oesophageal Doppler cardiac output monitoring for 16 hours (overnight) after their operation. Participants in the other group receive standard care with the probe in place but not used for monitoring. We then compare the outcomes of the two groups during their hospital stay and at follow-up.

What are the possible benefits and risks of participating?
Oesophageal Doppler monitoring has already been tested in cardiac and trauma patients. Patients can request early removal of the probe before the end of the 16-hour monitoring period if they wish. Patients who may be at risk of nasal or oesophageal injury from the probe are excluded from the study.

Where is the study run from?
St Thomas' Hospital (UK).

When is the study starting and how long is it expected to run for?
May 2011 to October 2012

Who is funding the study?
Guy's and St. Thomas' Charity (UK).

Who is the main contact?
Mr Jonathan van Dellen

Trial website

Contact information



Primary contact

Mr Andrew Williams


Contact details

Department of Colorectal Surgery
St Thomas' Hospital
Westminster Bridge Road
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number

RJ1 11/N160

Study information

Scientific title

Effect on clinical outcome of extension of oesophageal Doppler goal-directed fluid optimisation into the post-operative recovery period: a randomised control trial.


Study hypothesis

Extension of OD-guided goal-directed fluid optimisation into the immediate 16-hour post-operative period, in high risk colorectal ERP patients, achieves an oxygen delivery index ≥600ml/min/ m2 for the majority of the duration of this period, and subsequently improves patient outcomes.

Ethics approval

NRES Committee London - Westminster, 06/04/2011, ref: 11/H0802/9

Study design

Single-centre prospective single-blinded (assessor blinded to outcomes) randomised control study within an academic tertiary referral hospital setting

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Improving perioperative care for elective colorectal surgery within an Enhanced Recovery Programme


Intervention group will have 16 hours post-operative oesophageal Doppler cardiac output monitoring with nurse-led stroke volume optimisation in an overnight intensive recovery (OIR) unit.

Control group will have an equivalent OIR admission without cardiac output monitoring (nasal oesophageal Doppler probe still in-situ for 16h measurements).

Follow-up of outcomes during hospital admission and standard telephone and outpatient clinic follow-up.

Intervention type



Not Applicable

Drug names

Primary outcome measures

Post-operative length of stay (in days)

Secondary outcome measures

1. Oxygen delivery index at end of 16h post-operative recovery period
2. Mean oxygen delivery index over 16h post-operative recovery period
3. Morbidity
4. Functional recovery (mobility and return of gastrointestinal function)
5. In-hospital and 30-day mortality

Overall trial start date


Overall trial end date


Reason abandoned


Participant inclusion criteria

1. Consecutive elective or semi-elective patients due to undergo colorectal surgery as part of Enhanced Recovery Protocol involving resection or anastamosis of bowel
2. High-risk participants will be defined as having (1) pre-operative ASA grade III+ OR anaerobic threshold <11 ml/min/kg on cardiopulmonary exercise testing OR undergoing major complex surgery (as per OPCS 4.5 classification - Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures)
3. Ages 18 and over (no upper limit)

Participant type


Age group




Target number of participants


Participant exclusion criteria

1. Emergency surgery
2. Lack of capacity to consent
3. Pregnancy
4. Contraindications to oesophageal Doppler probe:
4.1. Nasal injuries or polyps
4.2. Severe oesophageal/laryngeal/pharyngeal disease
4.3. Recent oesophageal/laryngeal/pharyngeal surgery
4.4. Thoracic aortic aneurysm
4.5. Severe bleeding diathesis
4.6. Long-term systemic steroid therapy
4.7. Portal hypertension

All excluded patients from patient groups to be reported in results

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

St Thomas' Hospital
United Kingdom

Sponsor information


Guy's & St Thomas' NHS Foundation Trust (UK)

Sponsor details

c/o Karen Ignation
United Kingdom

Sponsor type

Hospital/treatment centre



Funder type


Funder name

Guy's and St. Thomas' Charity (UK) ref: G100706

Alternative name(s)

Funding Body Type

private sector organisation

Funding Body Subtype

other non-profit


United Kingdom

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes