• Matthew D Wiles, William J D Whiteley, Chris G Moran, and Iain K Moppett.
• Division of Anaesthesia and Intensive Care, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
• Trials. 2011 Jan 1;12:213.

BackgroundApproximately 70,000 patients/year undergo surgery for repair of a fractured hip in the United Kingdom. This is associated with 30-day mortality of 9% and survivors have a considerable length of acute hospital stay postoperatively (median 26 days). Use of oesophageal Doppler monitoring to guide intra-operative fluid administration in hip fracture repair has previously been associated with a reduction in hospital stay of 4-5 days. Most hip fracture surgery is now performed under spinal anaesthesia. Oesophageal Doppler monitoring may be unreliable in the presence of spinal anaesthesia and most patients would not tolerate the probes. An alternative method of guiding fluid administration (minimally-invasive arterial pulse contour analysis) has been shown to reduce length of stay in high-risk surgical patients but has never been studied in hip fracture surgery.MethodsSingle-centre randomised controlled parallel group trial. Randomisation by website using computer generated concealed tables.SettingUniversity hospital in UK.Participants128 patients with acute primary hip fracture listed for operative repair under spinal anaesthesia and aged > 65 years.InterventionStroke volume guided intra-operative fluid management. Continuous measurement of SV recorded by a calibrated cardiac output monitor (LiDCOplus). Maintenance fluid and 250 ml colloid boluses given to achieve sustained 10% increases in stroke volume.Control Groupfluid administration at the responsible (blinded) anaesthetist's discretion. The intervention terminates at the end of the surgical procedure and post-operative fluid management is at the responsible anaesthetist's discretion.Primary Outcomelength of acute hospital stay is determined by a blinded team of clinicians. Secondary outcomes include number of complications and total cost of care. Funding NIHR/RfPB: PB-PG-0407-13073.Trial Registration NumberTrial RegistrationCurrent Controlled Trials ISRCTN88284896.

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