Patients in TEE group will be given crystalloid fluids during surgery guided by LVEDA cm2 to be maintained between 10 -18 cm2 , if LVEDA < 10 cm2 then 200ml colloid bolus will be given and increase in LVEDA noted.

Patients in CVP group will be given crystalloid fluids during surgery guided by CVP values to be maintained between 10 -16 cms of water H2O ,if CVP value < 10 cms H2O then 200 ml colloid bolus will be given and increase in CVP value noted.

Goal Directed Fluid Therapy

Placement of Transoesophageal echocardiography probe in TEE group to measure Left ventricular end diastolic area cm2

LVEDA cm2 guided intraoperative fluid in TEE /Study Group

Ultrasound guided Internal Jugular Vein catheter placement in CVP group to measure CVP value cms H2O .

CVP guided intraoperative fluid in CVP / Control group

Anita Kulkarni

Transesophageal Echocardiology Measured Left Ventricular End Diastolic Area as Guide for Administering Goal Directed Fluids During Major Oncosurgeries

Transesophageal Echocardiology Measured Left Ventricular End Diastolic Area (LVEDA) as Guide for Intraoperative Goal Directed Fluid Therapy (GDFT) in Major Oncosurgeries

During the surgery Study group will receive fluids ( crystalloids and bolus colloids) guided by LVEDA cm2 and Control group will receive fluids (crystalloids and bolus colloids) guided by CVP cms H20

In both the groups through completion of surgery and at postoperative 24 hours and postoperative 48 hours serum lactate levels will be measured .

In both groups serum creatinine in milligrams per decilitre will be measured at postoperative 24 and postoperative 48 hours.

In both the groups postoperative stay in the ICU will be noted in days.

Dr Anita Kulkarni

Principal Investigator

Rajiv Gandhi Cancer Institute & Research Center, India

During surgery Control group of patients will receive CVP guided fluids Study group of patients will receive TEE measured LVEDA guided fluids

Patients will be randomly allotted to either TEE or CVP Group according to computer generated randomization thus will be masked .

ADHD

Medication Other

motor measurement by actometer and saliva collection for measurement of saliva cortisol and saliva alpha amylase

motor measurement and saliva collection

Dr med Kurt von Siebenthal

Dr med Roland Kägi

Atomoxetine, Diurnal Profiles of Cortisol and α-amylase

Atomoxetine, Diurnal Profiles of Cortisol and α-amylase, Possible Biological Markers of Treatment Success

diurnal profile of saliva cortisol and saliva alpha amylase

noradrenaline/кариес

Transesophageal Echocardiology Measured Left Ventricular End Diastolic Area as Guide for Administering Goal Directed Fluids During Major Oncosurgeries

Atomoxetine, Diurnal Profiles of Cortisol and α-amylase

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