Coronary disease & ACSRandomised controlled trial
Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial
- Randomised controlled trial
- assessor blinded
- single centre
Authors' conclusion
Guided care by use of multisite near-infrared spectroscopy and haemodynamic monitoring effectively maintained tissue oxygenation near baseline levels compared with usual care. However, no clear evidence was noted that this approach reduced the incidence of major postoperative complications.
Study context
- Population
- Patients aged ≥60 years scheduled for elective off-pump CABG, tertiary teaching hospital in China967 + 974 analysed
- Participants
- 1,960 patients
- Comparison
- Guided care vs Usual care
- Guided caren = 967
- Usual caren = 974reference
- Primary endpoint
- Composite of postoperative complications (cerebral, cardiac, respiratory, renal, infectious, mortality)
- Follow-up
- 30 days
Primary result
As reported in the abstract
Relative risk
0.99
95% CI 0.90–1.08
P = 0.83
Events by treatment group
Guided care vs Usual care
RR 0.99 (95% CI 0.90–1.08); P = 0.83
Secondary outcomes
Pneumonia
| Outcome | Guided care | Usual care |
|---|---|---|
| AUC of tissue oxygen saturation outside ±10% baseline range during anaesthesia | ||
| Left forehead | 32.4 | 57.6 |
| Right forehead | 37.9 | 62.6 |
| Forearm | 14.8 | 44.7 |
- AUC of tissue oxygen saturation outside ±10% baseline range during anaesthesia: P<0.001 for each site
- Pneumonia: not statistically significant after adjusting for multiple comparisons
Secondary outcomes (composite components, new-onset AF, hospital length of stay)
- No secondary outcomes differed significantly between groups
Original publication
Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial. BMJ. Published 24 March 2025. doi:10.1136/bmj-2024-082104
Summarised from the published abstract; every number is checked against it