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Article History

Received: 19 August 2025

Accepted: 14 March 2026

First Online: 28 March 2026

Declarations

:

: Ethics committee approval is obtained for each site prior to patient recruitment. The primary ethics approval was obtained from the ethics committee Hamburg (Ethikkommission der Ärztekammer Hamburg, Hamburg, Germany) on 15 December 2022 (registration number 2022–100955-BO-ff). Each participating center obtained secondary approval from their respective ethics committees before initiating patient recruitment, ensuring compliance with local regulatory requirements. All participating patients must provide written informed consent, obtained by dedicated trial personnel before inclusion. Across all sites, potential participants are identified during preoperative assessment in the days preceding surgery, after which trained staff approach eligible individuals to discuss the trial. Patients receive ethically approved written information and consent documents in their native language and are given sufficient time to review materials, ask questions, and consult with family or physicians. Consent must be signed before any trial-specific procedures, including preoperative baseline cardiac index measurement. Patients are informed that they may withdraw at any time without consequences for their clinical care. Completed consent forms are stored securely in compliance with data protection requirements and Good Clinical Practice. Site initiation visits include dedicated training to ensure uniform conduct of the consent process across centers.

: Not applicable.

: MF is a consultant for Edwards Lifesciences (Irvine, CA, USA) and Vygon (Ecouen, France). MF has received honoraria for consulting and giving lectures from CNSystems Medizintechnik (Graz, Austria).EKA founder of spin-out company, WARD24/7 ApS, Copenhagen, Denmark, with the aim of pursuing the regulatory and commercial activities of the WARD-project (developing a clinical support system for continuous wireless monitoring of vital signs). WARD24/7 ApS has obtained license agreement for any WARD-project software and patents. One patent has been filed: “Wireless Assessment of Respiratory and circulatory Distress (WARD), EP 21184712.4 and EP 21205557.8”.ME has no conflict of interest to declare.AK received honoraria for giving lectures from Edwards Lifesciences (Irvine, CA, USA).ASM has received speaker honoraria from Edwards Lifesciences (Irvine, CA, USA).CSM: founder of a spin-out company, WARD24/7 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD-project (Wireless Assessment of Respiratory and circulatory Distress, a project developing a clinical support system for continuous wireless monitoring of vital signs). WARD24/7 ApS has obtained license agreement for any WARD-project software and patents. One patent has been filed: “Wireless Assessment of Respiratory and circulatory Distress (WARD), EP 21184712.4 and EP 21205557.8”.SR has no conflict of interest to declare.MS has no conflict of interest to declare.RS has no conflict of interest to declare.MV has no conflict of interest to declare.BV is a consultant for TEVA-ratiopharm (Ulm, Germany) and has received honoraria for giving lectures from Edwards Lifesciences (Irvine, CA, USA), TEVA-ratiopharm and Vygon (Aachen, Germany).SZ has no conflict of interest to declare.AZ has no conflict of interest to declare.LK has no conflict of interest to declare.EV has no conflict of interest to declare.KK is a consultant for and has received honoraria for giving lectures from Edwards Lifesciences. KK is a consultant for Vygon (Aachen, Germany).BS is a consultant for Edwards Lifesciences (Irvine, CA, USA), Philips North America (Cambridge, MA, USA), GE Healthcare (Chicago, IL, USA), Vygon (Aachen, Germany), Masimo (Neuchâtel, Switzerland), Retia Medical (Valhalla, NY, USA), Maquet Critical Care (Solna, Sweden), Pulsion Medical Systems (Feldkirchen, Germany), Dynocardia (Cambridge, MA, USA), RDS (Strasbourg, France). BS has received institutional restricted research grants from Edwards Lifesciences, Baxter (Deerfield, IL, USA), GE Healthcare, Masimo, Philips Medizin Systeme Böblingen (Böblingen, Germany), CNSystems Medizintechnik (Graz, Austria), Pulsion Medical Systems, Vygon, Retia Medical, Osypka Medical (Berlin, Germany). BS has received honoraria for giving lectures from Edwards Lifesciences, Philips Medizin Systeme Böblingen, Baxter, GE Healthcare, Masimo, CNSystems Medizintechnik, Getinge (Gothenburg, Sweden), Pulsion Medical Systems, Vygon, Ratiopharm (Ulm, Germany). BS is an Editor of the British Journal of Anaesthesia.