الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Goal-directed fluid therapy which is based on the use of dynamic parameters to guide intravenous and inotropic therapy is frequently applied with the intention to optimize peri-operative hemodynamic profiles and maximize oxygen delivery in patients undergoing major abdominal surgery. Dynamic indices as stroke volume variability and pulse pressure variation have emerged as promising predictors in last decade, and have been proven to predict fluid responsiveness far better than static measures. Electrical Cardiometry is a method for the non-invasive determination of stroke volume (SV), cardiac output (CO), and other hemodynamic parameters in adults, children and neonates. We have conducted a prospective randomized study on one hundred and eight patients of either sex undergoing elective major abdominal surgery in oncology center, Mansoura University. the patients were randomly divided into two equal groups, 54patients each, goal directed group (GDFT) and restrictive group (RFT). Randomization was carried out using to computer-randomized method. Hemodynamic variables from electrical cardiometry were obtained such as stroke volume (SV), stroke volume variation (SVV), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI), thoracic fluid content (TFC), corrected flow time (FTC), index of contractility (ICON), systolic time ratio (STR), oxygen delivery (DO2) and oxygen delivery index (DO2I). There was a non-significant lower number of hypotensive episodes in GDFT group and subsequently less additional boluses of colloids when compared with RFT group. Also, there was a statistically significant difference between both groups as regards total fluids administered intraoperatively and heart rate readings during the operation. There was no statistically significant difference between both groups as regards incidence of complications as acute kidney injury (AKI), burst abdomen, pneumonia, intestinal obstruction, pulmonary edema and post-operative ventilation. Conclusion: Goal directed fluid therapy using electrical cardiometry has been associated with a significant difference in the amount and type of fluids given in both groups. Intraoperative heat rate showed significant difference between the studied groups. There was a non-significant reduction in number and severity of hypotensive episodes with maintenance of hemodynamic stability and adequate plasma volume status when compared with restricted fluid therapy, with no differences in complications in both groups.