Traditional Versus Goal Directed Perioperative Fluid Therapy in High Risk Patients

Standard monitoring. The patient is connected to the LiDCOrapid monitor via an arterial line placed in a.radialis. A bolus of 500 ml Ringer acetate is given before anesthesia. If the stroke volume (SV) increases more than 10%, repeat the procedure until the SV is not increasing. After that, induction of anesthesia. Maintenance fluid is given as Ringer acetate 2ml/kg/t. Continuous monitoring of stroke volume variation (SVV). If SVV\> 10%, give a fluid bolus 6ml/kg Ringer acetate. Repeat until SVV \<10%. Bleeding is being replaced 1:1 with hydroxyethyl starch. SAG by bleeding \>1000ml. By fall in blood pressure and SVV \<10%, start vasoactive treatment with epinephrine. Postoperative is given Glucose 5% 80ml/h.