A 68-year-old man undergoing major colorectal surgery per Enhanced Recovery After Surgery (ERAS) protocol receives goal-directed intraoperative fluid therapy. Which intraoperative haemodynamic target best reduces postoperative complications in colorectal ERAS programmes?
- A Stroke volume variation (SVV) <13% and stroke volume optimisation with colloid boluses ✓
- B CVP of 8–12 mmHg with liberal crystalloid
- C Maintain urine output >1 mL/kg/h throughout surgery
- D Maintain systolic BP >100 mmHg with vasopressors alone
Correct answer: A. Stroke volume variation (SVV) <13% and stroke volume optimisation with colloid boluses
Explanation
Goal-directed fluid therapy (GDFT) using dynamic parameters such as stroke volume variation (SVV) or pulse pressure variation (PPV) reduces complications in major colorectal surgery within ERAS protocols. Targets: SVV <13% (indicating adequate preload) with fluid boluses to optimize stroke volume (Starling curve plateau), combined with vasopressors if MAP is low. CVP is a static preload marker proven unreliable in numerous trials. Urine output is a late and insensitive marker of hypovolaemia in the anaesthetised patient.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.