Library of Clinical Evidence


There is a large body of evidence to support the use of Deltex Medical’s technology. This includes an AHRQ Technology Assessment,  NICE recommendation, Randomized Controlled Trials (RCTs), published Audit studies, Reviews and Meta-Analyses, and Case Histories. Click here for a pdf version of the Deltex Medical Bibliography.


Intraoperative: EDM RCTs

Mythen, M.G. and Webb, A.R., Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg, 1995. 130(4): p. 423-9.

Sinclair, S., James, S., and Singer, M., Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ, 1997. 315(7113): p. 909-12.

Gan, T.J., Soppitt, A., Maroof, M., el-Moalem, H., Robertson, K.M., Moretti, E., Dwane, P., and Glass, P.S., Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology, 2002. 97(4): p. 820-6.

enn, R., Steele, A., Richardson, P., Poloniecki, J., Grounds, M., and Newman, P., Randomized controlled trial to investigate influence of the fluid challenge on duration of hospital stay and perioperative morbidity in patients with hip fractures. Br J Anaesth, 2002. 88(1): p. 65-71.

Wakeling, H.G., McFall, M.R., Jenkins, C.S., Woods, W.G., Miles, W.F., Barclay, G.R., and Fleming, S.C., Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth, 2005. 95(5): p. 634-42.

Noblett, S.E., Snowden, C.P., Shenton, B.K., and Horgan, A.F., Randomized clinical trial assessing the effect of Doppler-optimized fluid management on outcome after elective colorectal resection. The Br J Surg, 2006. 93(9): p. 1069-76.

Senagore, A.J.E., Emery, T., Luchtefeld, M., Kim, D., Dujovny, N., Hoedema, R., Fluid management for laparoscopic colectomy: a prospective, randomized assessment of goal-directed administration of balanced salt solution or hetastarch coupled with an enhanced recovery program. Dis Colon Rectum, 2009. 52(12): p. 1935-40.

Pillai, P.M., McEleavy, I., Gaughan, M., Snowden, C., Nesbitt, I., Durkan, G., Johnson, M., Cosgrove, J., Thorpe, A., A double-blind randomized controlled clinical trial to assess the effect of Doppler optimized intraoperative fluid management on outcome following radical cystectomy. J Urol, 2011. 186(6): p. 2201-6.

Brandstrup, B., Svendsen, P.E., Rasmussen, M., Belhage, B., Rodt, S.A., Hansen, B., Moller, D.R., Lundbech, L.B., Andersen, N., Berg, V., Thomassen, N., Andersen, S.T., and Simonsen, L., Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near-maximal stroke volume or zero fluid balance? Br J Anaesth, 2012. 109(2): p. 191-9.

Challand, C.S., Struthers, R., Sneyd, J. R., Erasmus, P. D., Mellor, N., Hosie, K. B., Minto, G., Randomized controlled trial of intraoperative goal-directed fluid therapy in aerobically fit and unfit patients having major colorectal surgery. Br J Anaesth, 2012. 108(1): p. 53-62.

Srinivasa, S., Taylor, M.H., Singh, P.P., Yu, T.C., Soop, M., and Hill, A.G., Randomized clinical trial of goal-directed fluid therapy within an enhanced recovery protocol for elective colectomy. Br J Surg, 2013. 100(1): p. 66-74.

Zakhaleva, J., Tam, J., Denoya, P.I., Bishawi, M., and Bergamaschi, R., The impact of intravenous fluid administration on complication rates in bowel surgery within an enhanced recovery protocol: a randomized controlled trial. Colorectal Dis, 2013. 15(7): p. 892-9.

McKenny, M., Conroy, P., Wong, A., Farren, M., Gleeson, N., Walsh, C., O’Malley, C., and Dowd, N., A randomised prospective trial of intra-operative oesophageal Doppler-guided fluid administration in major gynaecological surgery. Anaesthesia, 2013.

El Sharkawy, O.A., Refaat, E.K., Ibraheem, A.E.M., Mahdy, W.R., Fayed, N.A., Mourad, W.S., Abd Elhafez, H.S., and Yassen, K.A., Transoesophageal Doppler compared to central venous pressure for perioperative hemodynamic monitoring and fluid guidance in liver resection. Saudi J Anaesth, 2013. 7(4): p. 378-86.

Intraoperative: EDM Audit

Kuper, M., Gold, S.J., Callow, C., Quraishi, T., King, S., Mulreany, A., Bianchi, M., and Conway, D.H., Intraoperative fluid management guided by oesophageal Doppler monitoring. BMJ, 2011. 342: p. d3016.

Feldheiser, A., Conroy, P., Bonomo, T., Cox, B., Ruiz Garces, T., and Spies, C., Development and feasibility study of an algorithm for intraoperative goal-directed haemodynamic management in noncardiac surgery. J Int Med Res, 2012. 40(4): p. 1227-41.

Chattopadhyay, S., Mittal, S., Christian, S., Terblanche, A.L., Patel, A., Biliatis, I., Kucukmetin, A., Naik, R., and Galaal, K., The role of intraoperative fluid optimization using the esophageal Doppler in advanced gynecological cancer: early postoperative recovery and fitness for discharge. Int J Gynecol Cancer, 2013. 23(1): p. 199-207.

Figus, A., Wade, R.G., Oakey, S., and Ramakrishnan, V.V., Intraoperative esophageal Doppler hemodynamic monitoring in free perforator flap surgery. Ann Plast Surg, 2013. 70(3): p. 301-7.

Intraoperative: EDM Unpublished

Shi, C., Morse, L.S., Douning, L.K., Chi, L., and Jessen, M.E. Optimizing intraoperative volume management during coronary bypass surgery. American Society of Anesthesiologists, 2000: p. A-347.

Dodd, T.E.M., McCormack, R.N., Dorman, F., Green, R., Bromilow, J. Using the oesophageal Doppler monitor in elective colorectal surgery: is it worth it? [Poster]. in Annual Meeting of Wessex Anaesthetists in Training. 2004. Poole, UK.

McKenny, M., Dowd, N., and O’Malley, C. Oesophageal Doppler Monitor guided fluid management in laparoscopic gastrointesintal surgery. in Anaesthesia & Perioperative Medicine. 2011. Dingle, Ireland.

Munoz, C.A.F., Rojas, J.L.T., Bermudez, O.I.G., Rios, D.E.M., Escobar, E.M. Intraoperative oesophageal Doppler during emergency abdominal surgery [Abstract #966]. in World Congress of Anaesthesiologists. 2012. Buenos Aires.

Intraoperative: Other EDM

Conway, D.H., Mayall, R., Abdul-Latif, M.S., Gilligan, S., Tackaberry, C., Randomised controlled trial investigating the influence of intravenous fluid titration using oesophageal Doppler monitoring during bowel surgery. Anaesthesia, 2002. 57(9): p. 845-9.

Mannova, J.H., Silhart, Z., Sevcik, P., and Prokes, A., Perioperative haemodynamic monitoring by oesophageal Doppler improves outcome of patients with abdominal aortic aneurysm repair. Bratislavske lekarske listy, 2013. 114(2): p. 78-83.

Postoperative/ICU: EDM RCTs

McKendry, M., McGloin, H., Saberi, D., Caudwell, L., Brady, A.R., and Singer, M., Randomised controlled trial assessing the impact of a nurse delivered, flow monitored protocol for optimisation of circulatory status after cardiac surgery. BMJ, 2004. 329(7460): p. 258.

El Sharkawy, O.A., Refaat, E.K., Ibraheem, A.E.M., Mahdy, W.R., Fayed, N.A., Mourad, W.S., Abd Elhafez, H.S., and Yassen, K.A., Transoesophageal Doppler compared to central venous pressure for perioperative hemodynamic monitoring and fluid guidance in liver resection. Saudi J Anaesth, 2013. 7(4): p. 378-86.

Postoperative/ICU: ODM Unpublished

van Dellen, J., McCorkell, S., and Williams, A., Randomised controlled trial of extended post-operative goal-directed fluid therapy using oesophageal doppler within an enhanced recovery programme for elective colorectal patients [Abstract P056]. Colorectal Dis, 2013. 15(Suppl 1): p. 30.

Postoperative/ICU: Other ODM

Chytra, I., Pradl, R., Bosman, R., Pelnar, P., Kasal, E., Zidkova, A., Esophageal Doppler-guided fluid management decreases blood lactate levels in multiple-trauma patients: a randomized controlled trial. Crit Care, 2007. 11(1): p. R24.

Systematic Reviews & Meta Analysis

Abbas, S.M., Hill, A. G., Systematic review of the literature for the use of oesophageal Doppler monitor for fluid replacement in major abdominal surgery. Anaesthesia, 2008. 63(1): p. 44-51.

Phan, T.D., Ismail, H., Heriot, A. G., Ho, K. M., Improving perioperative outcomes: fluid optimization with the esophageal Doppler monitor, a metaanalysis and review. J Am Coll Surg, 2008. 207(6): p. 935-41.

Walsh, S.R., Tang, T., Bass, S., and Gaunt, M.E., Doppler-guided intra-operative fluid management during major abdominal surgery: systematic review and meta-analysis. Int J Clin Pract, 2008. 62(3): p. 466-70.

Giglio, M.T., Marucci, M., Testini, M., and Brienza, N., Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: a meta-analysis of randomized controlled trials. Br J Anaesth, 2009. 103(5): p. 637-46.

Mowatt, G., Houston, G., Hernandez, R., de Verteuil, R., Fraser, C., Cuthbertson, B., Vale, L., Systematic review of the clinical effectiveness and cost-effectiveness of oesophageal Doppler monitoring in critically ill and high-risk surgical patients. Health Technol Assess, 2009. 13(7): p. iii-iv, ix-xii, 1-95.

Dalfino, L., Giglio, M.T., Puntillo, F., Marucci, M., and Brienza, N., Haemodynamic goal-directed therapy and postoperative infections: earlier is better. A systematic review and meta-analysis. Crit Care, 2011. 15(3): p. R154.

Hamilton, M.A., Cecconi., M., Rhodes, A., A systematic review and meta-analysis on the use of preemptive hemodynamic intervention to improve postoperative outcomes in moderate and high-risk surgical patients. Anesth Analg, 2011. 112(6): p. 1392-402.

Maeso, S., Callejo, D., Hernandez, R., Blasco, J.A., and Andradas, E., Esophageal Doppler monitoring during colorectal resection offers cost-effective improvement of hemodynamic control. Value Health, 2011. 14(6): p. 818-26.

Giglio, M., Dalfino, L., Puntillo, F., Rubino, G., Marucci, M., and Brienza, N., Haemodynamic goal-directed therapy in cardiac and vascular surgery. A systematic review and meta-analysis. Interact Cardiovas Thorac Surg, 2012. 15(5): p. 878-87.

Grocott, M.P., Dushianthan, A., Hamilton, M.A., Mythen, M.G., Harrison, D., and Rowan, K., Perioperative increase in global blood flow to explicit defined goals and outcomes following surgery. Cochrane Database Syst Rev, 2012. 11: p. CD004082.


Singer, M., Clarke, J., Bennett, E. D., Continuous hemodynamic monitoring by esophageal Doppler. Crit Care Med, 1989. 17(5): p. 447-52.

Singer, M. and Bennett, E.D., Noninvasive optimization of left ventricular filling using esophageal Doppler. Crit Care Med, 1991. 19(9): p. 1132-7.

Klotz, K.F., Klingsiek, S., Singer, M., Wenk, H., Eleftheriadis, S., Kuppe, H., and Schmucker, P., Continuous measurement of cardiac output during aortic cross-clamping by the oesophageal Doppler monitor ODM 1. Br J Anaesth, 1995. 74(6): p. 655-60.

Keyl, C., Rodig, G., Lemberger, P., and Hobbhahn, J., A comparison of the use of transoesophageal Doppler and thermodilution techniques for cardiac output determination. Eur J Anaesthesiol, 1996. 13(2): p. 136-42.

Krishnamurthy, B., McMurray, T.J., and McClean, E., The peri-operative use of the oesophageal Doppler monitor in patients undergoing coronary artery revascularisation. A comparison with the continuous cardiac output monitor. Anaesthesia, 1997. 52(7): p. 624-9.

Colbert, S., O’Hanlon, D.M., Duranteau, J., and Ecoffey, C., Cardiac output during liver transplantation. Can J Anaesth, 1998. 45(2): p. 133-8.

Lefrant, J.Y., Bruelle, P., Aya, A.G., Saissi, G., Dauzat, M., de La Coussaye, J.E., and Eledjam, J.J., Training is required to improve the reliability of esophageal Doppler to measure cardiac output in critically ill patients. Intensive Care Med, 1998. 24(4): p. 347-52.

Valtier, B., Cholley, B.P., Belot, J.P., de la Coussaye, J.E., Mateo, J., and Payen, D.M., Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. Am J Respir Crit Care Med, 1998. 158(1): p. 77-83.

Baillard, C., Cohen, Y., Fosse, J.P., Karoubi, P., Hoang, P., and Cupa, M., Haemodynamic measurements (continuous cardiac output and systemic vascular resistance) in critically ill patients: transoesophageal Doppler versus continuous thermodilution. Anaesth Intensive Care, 1999. 27(1): p. 33-7.

DiCorte, C.J., Latham, P., Greilich, P.E., Cooley, M.V., Grayburn, P.A., and Jessen, M.E., Esophageal Doppler monitor determinations of cardiac output and preload during cardiac operations. Ann Thorac Surg, 2000. 69(6): p. 1782-6.

Penny, J.A., Anthony, J., Shennan, A.H., De Swiet, M., and Singer, M., A comparison of hemodynamic data derived by pulmonary artery flotation catheter and the esophageal Doppler monitor in preeclampsia. Am J Obstet Gynecol, 2000. 183(3): p. 658-61.

Leather, H.A. and Wouters, P.F., Oesophageal Doppler monitoring overestimates cardiac output during lumbar epidural anaesthesia. Br J Anaesth, 2001. 86(6): p. 794-7.

Su, N.Y., Huang, C.J., Tsai, P., Hsu, Y.W., Hung, Y.C., Cheng, C.R., Cardiac output measurement during cardiac surgery: esophageal Doppler versus pulmonary artery catheter. Acta Anaesthesiol Sin, 2002. 40(3): p. 127-33.

Jaeggi, P., Hofer, C.K., Klaghofer, R., Fodor, P., Genoni, M., and Zollinger, A., Measurement of cardiac output after cardiac surgery by a new transesophageal Doppler device. J Cardiothorac Vasc Anesth, 2003. 17(2): p. 217-20.

Roeck, M., Jakob, S.M., Boehlen, T., Brander, L., Knuesel, R., and Takala, J., Change in stroke volume in response to fluid challenge: assessment using esophageal Doppler. Intensive Care Med, 2003. 29(10): p. 1729-35.

Seoudi, H.M., Perkal, M.F., Hanrahan, A., and Angood, P.B., The esophageal Doppler monitor in mechanically ventilated surgical patients: does it work? J Trauma, 2003. 55(4): p. 720-5; discussion 5-6.

Dark, P.M., Singer, M., The validity of trans-esophageal Doppler ultrasonography as a measure of cardiac output in critically ill adults. Intensive Care Med, 2004. 30(11): p. 2060-6.

Monnet, X., Rienzo, M., Osman, D., Anguel, N., Richard, C., Pinsky, M.R., and Teboul, J.L., Esophageal Doppler monitoring predicts fluid responsiveness in critically ill ventilated patients. Intensive Care Med, 2005. 31(9): p. 1195-201.

Chew, H.C., Devanand, A., Phua, G.C., and Loo, C.M., Oesophageal Doppler ultrasound in the assessment of haemodynamic status of patients admitted to the medical intensive care unit with septic shock. Ann Acad Med Singapore, 2009. 38(8): p. 699-703.

Phan, T.D., Kluger, R., Wan, C., Wong, D., and Padayachee, A., A comparison of three minimally invasive cardiac output devices with thermodilution in elective cardiac surgery. Anaesth Intensive Care, 2011. 39(6): p. 1014-21.

Guinot, P.G., de Broca, B., Abou Arab, O., Diouf, M., Badoux, L., Bernard, E., Lorne, E., and Dupont, H., Ability of stroke volume variation measured by oesophageal Doppler monitoring to predict fluid responsiveness during surgery. Br J Anaesth, 2013. 110(1): p. 28-33.

Monnet, X., Robert, J.M., Jozwiak, M., Richard, C., and Teboul, J.L., Assessment of changes in left ventricular systolic function with oesophageal Doppler. Br J Anaesth, 2013.


Tibby, S.M., Hatherill, M., and Murdoch, I.A., Use of transesophageal Doppler ultrasonography in ventilated pediatric patients: derivation of cardiac output. Critical care medicine, 2000. 28(6): p. 2045-50.

Tibby, S.M., Hatherill, M., Durward, A., and Murdoch, I.A., Are transoesophageal Doppler parameters a reliable guide to paediatric haemodynamic status and fluid management? Intensive care medicine, 2001. 27(1): p. 201-5.

Mohan, U.R., Britto, J., Habibi, P., de, M.C., and Nadel, S., Noninvasive measurement of cardiac output in critically ill children. Pediatr Cardiol, 2002. 23(1): p. 58-61.

Knirsch, W., Kretschmar, O., Tomaske, M., Stutz, K., Nagdyman, N., Balmer, C., Schmitz, A., Bettex, D., Berger, F., Bauersfeld, U., and Weiss, M., Cardiac output measurement in children: comparison of the Ultrasound Cardiac Output Monitor with thermodilution cardiac output measurement. Intensive Care Med, 2008. 34(6): p. 1060-4.

Schubert, S., Schmitz, T., Weiss, M., Nagdyman, N., Huebler, M., Alexi-Meskishvili, V., Berger, F., and Stiller, B., Continuous, non-invasive techniques to determine cardiac output in children after cardiac surgery: evaluation of transesophageal Doppler and electric velocimetry. J Clin Monit Comput, 2008. 22(4): p. 299-307.

Fleck, T., Schubert, S., Stiller, B., Redlin, M., Ewert, P., Nagdyman, N., and Berger, F., Capability of a new paediatric oesophageal Doppler monitor to detect changes in cardiac output during testing of external pacemakers after cardiac surgery. J Clin Monit Comput, 2011. 25(6): p. 419-25.

Raux, O., Spencer, A., Fesseau, R., Mercier, G., Rochette, A., Bringuier, S., Lakhal, K., Capdevila, X., and Dadure, C., Intraoperative use of transoesophageal Doppler to predict response to volume expansion in infants and neonates. Br J Anaesth, 2012. 108(1): p. 100-7.

Comparison with Other Technologies

Meng, L., Tran, N.P., Alexander, B.S., Laning, K., Chen, G., Kain, Z.N., Cannesson, M., The impact of phenylephrine, ephedrine, and increased preload on third-generation Vigileo-FloTrac and esophageal doppler cardiac output measurements. Anesth Analg, 2011. 113(4): p. 751-7.

Conway, D.H., Hussain, O.A., and Gall, I., A comparison of noninvasive bioreactance with oesophageal Doppler estimation of stroke volume during open abdominal surgery: An observational study. Eur J Anaesthesiol, 2013. 30(8): p. 501-8.

Nordstrom, J., Hallsjo-Sander, C., Shore, R., and Bjorne, H., Stroke volume optimization in elective bowel surgery: a comparison between pulse power wave analysis (LiDCOrapid) and oesophageal Doppler (CardioQ). Br J Anaesth, 2013. 110(3): p. 374-80.

Davies, S.J., Minhas, S., Wilson, R.J., Yates, D., and Howell, S.J., Comparison of stroke volume and fluid responsiveness measurements in commonly used technologies for goal-directed therapy. J Clin Anesth, 2013.

Relevant Review Studies

Laupland, K.B. and Bands, C.J., Utility of esophageal Doppler as a minimally invasive hemodynamic monitor: a review. Can J Anaesth, 2002. 49(4): p. 393-401.

Cholley, B.P. and Singer, M., Esophageal Doppler: noninvasive cardiac output monitor. Echocardiography, 2003. 20(8): p. 763-9.

King, S.L. and Lim, M.S., The use of the oesophageal Doppler monitor in the intensive care unit. Crit Care Resusc, 2004. 6(2): p. 113-22.

Grocott, M.P., Mythen, M.G., and Gan, T.J., Perioperative fluid management and clinical outcomes in adults. Anesth Analg, 2005. 100(4): p. 1093-106.

Roche, A.M., Miller, T.E., and Gan, T.J., Goal-directed fluid management with trans-oesophageal Doppler. Best Pract Res Clin Anaesthesiol, 2009. 23(3): p. 327-34.

Schober, P., Loer, S.A., and Schwarte, L.A., Perioperative hemodynamic monitoring with transesophageal Doppler technology. Anesth Analg, 2009. 109(2): p. 340-53.

Schober, P., Loer, S.A., and Schwarte, L.A., Transesophageal Doppler devices: A technical review. J Clin Mon Comput, 2009. 23(6): p. 391-401.

Singer, M., Oesophageal Doppler. Curr Opin Crit Care, 2009. 15(3): p. 244-8.

Singer, M., Oesophageal Doppler monitoring: should it be routine for high-risk surgical patients? Curr Opin Anaesthesiol, 2011. 24(2): p. 171-6.

Marik, P.E., Noninvasive cardiac output monitors: a state-of the-art review. J Cardiothorac Vasc Anesth, 2013. 27(1): p. 121-34.


Sun, J.X., Reisner, A.T., Saeed, M., and Mark, R.G., Estimating Cardiac Output from Arterial Blood Pressure Waveforms: a Critical Evaluation using the MIMIC II Database, Harvard-MIT Division of Health Sciences and Technology, MIT: Cambridge, MA, USA.

Sun, J.X., Cardiac output estimation using aterial blood pressure waveforms, in Electrical Engineering and Computer Science 2006, Massachusettes Institute of Technology.

Sun, J.X., Reisner, A.T., Saeed, M., Heldt, T., and Mark, R.G., The cardiac output from blood pressure algorithms trial. Crit Care Med, 2009. 37(1): p. 72-80.

Caillard, A., Dubreuil, G., M’Bakulu, E., Tantot, A., Bart, F., Gayat, E., Madadaki, C., Vallee, F., and Mebazaa, A., Comparaison du débit cardiaque mesuré par doppler œsophagien et par 9 algorithmes d’analyse du contour de l’onde de pouls au cours d’épreuves thérapeutiques. Ann Fr Anesth Reanim, 2013. 32(S1): p. A389.

Monge Garcia, M.I., Gracia Romero, M., Gil Cano, A., Rhodes, A., Grounds, R.M., and Cecconi, M., Impact of arterial load on the agreement between pulse pressure analysis and esophageal Doppler. Crit Care, 2013. 17(3): p. R113.


Ghosh, S., Arthur, B., and Klein, A.A., NICE guidance on CardioQ(TM) oesophageal Doppler monitoring. Anaesthesia, 2011. 66(12): p. 1081-3. [and responses]

Campbell, B., Innovation, NICE, and CardioQ. Br J Anaesth, 2012. 108(5): p. 726-9.

Pinsky, M.R., O’Brien, T., Green, D., and Jonas, M., Technology comparison studies require precise reference controls to be valid [Letter]. Br J Anaesth, 2012. [and response]

Morris, C., Oesophageal Doppler monitoring, doubt and equipoise: evidence based medicine means change. Anaesthesia, 2013.

Physiology & the Need for Fluid Optimization

Fiddian-Green, R.G., Splanchnic ischaemia and multiple organ failure in the critically ill. Ann R Coll Surg Engl, 1988. 70(3): p. 128-34.

Deitch, E.A., The role of intestinal barrier failure and bacterial translocation in the development of systemic infection and multiple organ failure. Arch Surg, 1990. 125(3): p. 403-4.

Shoemaker, W.C.A., Apple, P. L.; Kram, H. B., Role of oxygen debt in the development of organ failure sepsis, and death in high-risk surgical patients. Chest, 1992. 102(1): p. 208-15.

Hamilton-Davies, C., Mythen, M.G., Salmon, J.B., Jacobson, D., Shukla, A., and Webb, A.R., Comparison of commonly used clinical indicators of hypovolaemia with gastrointestinal tonometry. Intensive Care Med, 1997. 23(3): p. 276-81.

Khuri, S.F.H., W. G.; DePalma, R. G.; Mosca, C.; Healey, N. A.; Kumbhani, D. J., Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg, 2005. 242(3): p. 326-41; discussion 41-3.

Kimberger, O., Arnberger, M., Brandt, S., Plock, J., Sigurdsson, G.H., Kurz, A., and Hiltebrand, L., Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon. Anesthesiology, 2009. 110(3): p. 496-504.

Bundgaard-Nielsen, M.J., C. C.; Secher, N. H.; Kehlet, H., Functional intravascular volume deficit in patients before surgery. Acta Anaesthesiol Scand, 2010. 54(4): p. 464-9.

Enhanced Recovery

Kehlet, H., Multimodal approach to control postoperative pathophysiology and rehabilitation. British journal of anaesthesia, 1997. 78(5): p. 606-17.

Fearon, K.C., Ljungqvist, O., Von Meyenfeldt, M., Revhaug, A., Dejong, C.H., Lassen, K., Nygren, J., Hausel, J., Soop, M., Andersen, J., Kehlet, H., Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr, 2005. 24(3): p. 466-77.

Lassen, K., Soop, M., Nygren, J., Cox, P.B., Hendry, P.O., Spies, C., von Meyenfeldt, M.F., Fearon, K.C., Revhaug, A., Norderval, S., Ljungqvist, O., Lobo, D.N., and Dejong, C.H., Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg, 2009. 144(10): p. 961-9.

Ramirez, J.M., Blasco, J.A., Roig, J. V., Maeso-Martinez, S., Casal, J.E., Esteban, F., Lic, D.C., Enhanced recovery in colorectal surgery: a multicentre study. BMC Surg, 2011. 11: p. 9.

Mythen, M.G., Swart, M., Acheson, N., Crawford, R., Jones, K., Kuper, M., McGrath, J. S., Horgan, A.F., Perioperative fluid management: Consensus statement from the enhanced recovery partnership. Perioperative Medicine, 2012. 1(2).

NHS Enhanced Recovery Partnership Programmme. Fulfilling the potential: A better journey for patients and a better deal for the NHS, 2012.  NHS Improvement


NHS Technology and Adoption Centre (NTAC). ‘How to why to’ guide – Doppler Guided Intraoperative Fluid Management. NTAC

Powell-Tuck, J., Gosling, P., Lobo, D. N., Allison, S.P., Carlson, G.L., Gore, M., Lewington, A.J., Pearse, R.M., Mythen, M.G., British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients.

National Institute for Health and Clinical Excellence (NICE). CardioQ-ODM Oesophageal Doppler Monitor. NICE MTG3, 2011.

Innovation Health and Wealth: Accelerating Adoption and Diffusion in the NHS., 2011.