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Fig. 2 | Perioperative Medicine

Fig. 2

From: Clinical and economic impact of goal-directed fluid therapy during elective gastrointestinal surgery

Fig. 2

Intraoperative goal-directed algorithm. SV stroke volume, SBP systolic blood pressure, MAP mean artery pressure. Maintained dose of infusion of crystalloid during surgery was 2~ 4 mL/kg/h for open procedure and 1~ 2 mL/kg/h for laparoscopic procedure. After incision for open cases and after pneumoperitoneum for laparoscopic cases, patients received a 200-mL colloid bolus over 5–10 min. If SV increased by > 10%, the bolus was repeated until it increased by < 10%. Once reached, the SV plateau value was used as a target value during the entire surgical duration. Additional colloid boluses were given only if SV dropped by > 10% below the plateau value. In case of hypotension (SBP < 90 mmHg or MAP < 60 mmHg or MAP decrease > 20% from baseline) in fluid non-responders, an infusion of dobutamine was recommended if CI was < 2.5 L/min/m2, and ephedrine boluses of 5 to 15 mg or norepinephrine infusion were recommended if CI was > 2.5 L/min/m2. Protocol should not influence blood product administration

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