PMC

Algorithm for hemodynamic management in the control arm. If CVP< 8 mmHg, a 500 ml bolus of hydroxyethyl starch 130/0.4 (Voluven®) was infused over 30 min aiming at a CVP of 8 to 12 mmHg. The bolus can be repeated if the target is not reached. If CVP >12 mmHg, furosemide and/or nitroglycerin and/or dobutamine are used at the discretion of the attending physician. If MAP < 60 mmHg, norepinephrine is started at 0.05 μg.kg^-1.min^-1 with the option to increase at an increment of 0.05 μg.kg^-1.min^-1. If MAP > 100 mmHg, nitroglycerin is given at the dose range of 0.5 to 3.0 μg.kg^-1.min^-1. An RBC transfusion is triggered when Hb<7 g.dl^-1. ScvO₂ is maintained >70%. CVP, central venous pressure; Hb, hemoglobin; RBC, red blood cell; ScvO₂, central venous oxygen saturation.

Algorithm for hemodynamic management according to transpulmonary thermodilution-derived data. If ITBVI < 850 ml.m^-2, a 500 ml bolus of hydroxyethyl starch 130/0.4 (Voluven®) was infused over 30 min aiming at an ITBVI of 850 to 1000 ml.m^-2. The bolus can be repeated if the target is not reached. If ITBVI >1000 ml.m^-2, nitroglycerin and/or dobutamine are used based on MAP and CI. If EVLWI ≥10 ml/kg, furosemide is used. If MAP < 60 mmHg, norepinephrine is started at 0.05 μg.kg^-1.min^-1 with the option to increase at an increment of 0.05 μg.kg^-1.min^-1. If MAP > 100 mmHg, nitroglycerin is given at the dose range of 0.5 to 3.0 μg.kg^-1.min^-1. RBC transfusion is triggered when Hb <7 g.dl^-1, and if CI <2.5L.min^-1.m^-2 dobutamine is started at the dose of 2.5 μg.kg^-1.min^-1. The target is to maintain ScvO₂>70%. CI, cardiac output; EVLWI, extravascular lung water index; Hb, hemoglobin level; ITBVI, intrathoracic blood volume index; MAP, mean arterial pressure; RBC, red blood cell; ScvO₂, central venous oxygen saturation.