Maintaining satisfactory tissue perfusion is an essential of success during reconstructive free flap surgery following malign oral cavity tumours. Intra- and postoperative goal-directed fluid therapy is an appropriate tool for that. Continuous cardiac output monitoring based fluid loading (complemented with vasopressor and/or inotropes if necessary) might be superior to conventional, central venous and arterial pressure monitoring in terms of morbidity, complications, optimal fluid balance and days spent in hospital. However, there is no data describing the effects of goal-directed fluid therapy (crystalloid or colloid) on microcirculation of free flaps implanted in the oral cavity during the post-operative period. The aim of this study is to observe the effects of continuous macrohaemodynamic monitoring based, goal-directed fluid therapy on microcirculation of forearm flaps during the perioperative period.
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Changes of Pulse pressure variation during the operation and the post-operative 24 hours
Timeframe: 24 hours
Assesment of free falp microcirculation by laser dopler flowmetry method.
Timeframe: 24 hours
Total need of Norepinephrine and Dobutamine during surgery and the post-operative 24 hours.
Timeframe: 24 hours
Changes of Cardiac Index during the operation and the post-operative 24 hours.
Timeframe: 24 hours
Mean arterial pressure during the operation and the post-operative 24 hours.
Timeframe: 24 hours