Less Fluids and a More Physiological Approach

Despite the growing body of knowledge regarding perioperative hemodynamic optimization, we remain dubious and critical about the clinical applicability of the goal-directed therapy (GDT) and its real impact on postoperative outcome. Our Italian colleagues suggest that the aim of the GDT approach should be to optimize cardiac output (CO) or stroke volume (SV) intraoperatively and in the early 8-12 hours after surgery, particularly in high-risk patients and high-risk surgery.