| Sumario: | Background: Goal-directed therapy allows clinicians to optimize perfusion and volume status in patients postoperatively. Objective: To evaluate the effect of a machine learning algorithm to guide postoperative goal-directed fluid therapy in cardiac surgery patients. Methods: A goal-directed fluid therapy program was implemented in a single center for coronary artery bypass patients with ejection fraction greater than or equal to 45% (implementation period: May 15, 2023, to May 31, 2024). Patient outcomes were compared with outcomes in matched historical control patients (control period: January 3 to October 31, 2022). The primary outcome was acute kidney injury. Results: A total of 479 eligible patients were evaluated (246 in the control group and 233 in the goal-directed therapy group). The incidence of acute kidney injury on postoperative day 2 (P =.01), on postoperative day 7(P =.02), and at discharge (P =.008) was lower in the goaldirected therapy group than in the control group. Conclusions: Patients in the goal-directed therapy program had a lower incidence of acute kidney injury compared with historical control patients. Incorporating a machine learning algorithm to guide goal-directed fluid therapy was a safe and less invasive way to monitor selected patients in the intensive care unit after cardiac surgery.
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