Decreasing Postoperative Complications by Goal-Directed Fluid Therapy During Esophageal Resection

"Stroke Volume and Cardiac Index are measured with the Flotrac/Vigileo system and circulation is optimised~1. Crystalloid infusion (2,5 ml/kg/t) throughout surgery~2. 3 ml/kg Volulyte (synthetic colloid) is infused during 5 minutes and SV is measured directly before and 5 minutes after. If SV increases more than 10% the dose is repeated until no increase \> 10% is observed. A new dose is given if SV decreases more than 10% from the last value.~3. If despite optimal filling Cardiac Index (CI) is below 2,5 l/min/m2 infusion with dobutamin is started to attain CI \> 2,5.~4. If despite CI \> 2,5 Mean Arterial Pressure \<65 mmHg vasopressor (phenylephrine / norepinephrine) is started until MAP equals or is over 65."