Table 2 Algorithm of infusions and transfusion in the operating room and intensive care unit

Hemodynamics

ASA I and II patients without cardiac diseases or cerebral insufficiency:

  Stroke volume variation (SVV) <12 %

  Cardiac index (CI) > 2.5 L/min/m²

  MAD >60 mmHg

ASA III and IV patients or patients with cardiac diseases or cerebral insufficiency:

  SVV <12 %

  CI >2.5 L/min/m²

  MAD >70 mmHg

  Central venous oxygen saturation >70 % or mixed venous oxygen saturation >65 %

To reach the desired parameter:

  Start with infusion protocol (see below)

  If not successful within 15 minutes:

  Start with norepinephrine as first-choice vasopressor

Infusion protocol

  Replacement of urine output with Ringer’s acetate solution in a 1:1 ratio

  Additionally, 500 ml of crystalloids for insensible sweating

  Replacement of blood and protein losses dependent on treatment assignment, with either HA 5 % or HES 6 % in a 1:1 ratio up to a transfusion trigger point or a maximum of 50 ml/kg/day

  Additionally up to 1500 ml of colloids for the protein loss into the third compartment