EP436 - Can the use of noninvasive hemodynamic monitoring to guide intraoperative resuscitation reduce perioperative comorbidities within ERAS for colorectal surgery?

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Purpose/Background: Intraoperative hemodynamic monitoring is crucial for optimizing patient outcomes during colorectal surgery, where fluid management and tissue perfusion are pivotal. This study evaluates the use of the Acumen IQ Sensor as a tool for real-time hemodynamic assessment to guide resuscitation strategies in the surgical context of colorectal surgery in hopes of implementing its use into ERAS protocol for colorectal surgery at a single institution. The Acumen IQ Sensor leverages advanced algorithms to analyze mean arterial pressure, stroke volume, stroke volume variation, hypotension prediction index, dynamic arterial elastance, systolic slope, cardiac index and systemic vascular resistance. Prior studies have used this device in numerous surgical subspecialties including general, orthopedic, neurologic, gynecologic, urologic, cardiac, vascular and various oncologic surgical subspecialties. These studies have shown benefit to using this device intraoperatively including decreased hospital length of stay, decreased ICU length of stay, decreased intraoperative resuscitation, decreased need for mechanical ventilation in ICU patients and decrease postoperative co-morbidities like acute kidney injury.

Methods/Interventions: Data collection began in October 2024 and will continue through April 2025. This is a prospective cohort study involving patients undergoing elective colorectal surgeries utilizing the Acumen IQ Sensor to monitor hemodynamic parameters throughout surgery in addition to traditional monitoring techniques. The data collected is compared with other colorectal patients undergoing surgery that solely use the traditional monitoring techniques for hemodynamic monitoring intraoperatively. For each patient we analyze the intraoperative resuscitation as well as the postoperative clinical data including length of stay, evidence of acute kidney injury, evidence of surgical site infection, need for significant postoperative resuscitation and unplanned emergency department visits or hospital admissions within 30 days post operatively.

Results/Outcomes: The IRB for this study was approved this month. Data collection began this week. At the time of poster presentation, we plan to share preliminary data. Based on the targeted fluid resuscitation guided by the Acumen IQ Sensor, results will include analysis of intraoperative resuscitation, length of stay, evidence of acute kidney injury, evidence of surgical site infection, need for significant postoperative resuscitation and unplanned emergency department visits or hospital admissions within 30 days post operatively.

Conclusion/Discussion: This study highlights the Acumen IQ Sensor's potential to enhance intraoperative decision-making, allowing for personalized resuscitation strategies based on dynamic hemodynamic data. We hope our finding will suggest that integrating this advanced yet noninvasive monitoring technology into colorectal surgery could significantly improve patient outcomes, paving the way for broader applications in various surgical settings.