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Optimise with GDT for major abdominal surgery?

StarlingThis good-sized study and meta-analysis (in light of itself) suggests a goal-directed protocol doesn’t reduce 30 day mortality but does reduce complications (undefined). Look at the OPTIMIZE protocol and see what you think of it. Do you insist on perpetually being at the summit of the Starling curve using 5% dextrose, colloid boluses and  Dopexamine in all cases? If not then should you consider it, or do you think it’s a strange/dated protocol?

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