Another randomized controlled trial
demonstrating that the recipe book administration of larger quantities of
crystalloid (i.e., 12 ml/kg/hr irresepective of hemodynamics) around the time of major surgery is associated with a worse outcome. Note that the
patients in the “restricted group” receive a lower hourly rate (4 ml/kg/hr) plus targeted fluid boluses (of Lactated Ringer’s) guided by an
algorithm of rational hemodynamic endpoints. The unanswered qustion is, How would the patients have done if they had received colloid rather than crystalloid, guided by the same algorithm?
– Monty Mythen