Oesophageal doppler monitoring saves lives

The NIHR HTA has published its review of the clinical and cost-effectiveness of ODM in highrisk surgical and critically ill patients. ODM directly measures blood-flow from the heart during surgery, allowing the clinical team to better manage the patient (ODM-guided fluid management). The report recognises, that within the NHS, Deltex Medical’s Cardio-Q-ODM device is most widely used and that ODM is a simple and safe procedure. The HTA compared ODM with conventional clinical assessment and reported that ODM is likely to be cost-effective since the initial cost of ODM is compensated by reduced complications and shorter length of stay in hospital. The report assessed the potential economic impact of ODM for surgical patients under the Quality Adjusted Life Year (QALY) methodology used by the National Institute for Health and Clinical Excellence (NICE). The analysis showed ODM to be both more effective and less costly under virtually every scenario modelled and that the NHS would need to spend between £642 and £4,441 extra on each additional survivor of surgery before ODM would no longer be considered cost-effective. Deltex Medical’s managing director, Ewan Phillips, commented: “The NIHR review highlights the gold standard evidence that ODM significantly improves outcomes for patients undergoing surgery. The body has provided the NHS with the clinical evidence base it needs to help deliver the best care for patients undergoing surgery and we believe that the CardioQ-ODM should be formally recognised as a standard of care for NHS patients.” New British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients, highlighted in The British Journal of Surgery, provided detailed instructions on how to manage patients’ fluid levels. The guidelines indicate that the management of fluid status during surgery by minimally invasive means, such as ODM, can produce substantial benefits to a patient’s recovery.