Goal-directed fluid therapy is one of the most accepted strategies in intraoperative fluid therapy, although potential fluid overload is a possible drawback. Fluid overload has recently been shown to cause damage to the glycocalyx and to increase extravasation of fluids into the interstitial space. This study aims to determine whether liberal fluid administration during moderate surgery results in impairment to the endothelial glycocalyx and causes edema. Participants will be randomized to receive either a liberal or restrictive fluid protocol with vasopressor support. The investigators will measure interstitial edema by clinical signs, pulmonary congestion by ultrasound, and extracellular water by bioimpedance. Impairment of glycocalyx will be estimated by measuring blood levels of shedding markers. In addition, wound healing and early postoperative outcome will be estimated by POMS.
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Change from preoperative serum concentration of Heparan Sulfate.
Timeframe: Two hours after completion of surgery.
Change from preoperative serum concentration of Syndecan-1.
Timeframe: Two hours after completion of surgery.
Change from preoperative serum concentration of Hyaluronic Acid.
Timeframe: Two hours after completion of surgery.
Change from preoperative serum concentration of Sphingosine-1-Phosphate.
Timeframe: Two hours after completion of surgery.
Appearance of B-lines on lung ultrasonography.
Timeframe: Two hours after completion of surgery.
Early appearance of peripheral pitting edema.
Timeframe: Two hours after completion of surgery.
Late appearance of peripheral pitting edema.
Timeframe: During the first postoperative day.
Postoperative Morbidity Survey (POMS) Score.
Timeframe: During the first postoperative day.
Early change in the percentage of Total Body Water and Extracellular Water.
Timeframe: Immediately after completion of surgery.
Late change in the percentage of Total Body Water and Extracellular Water.
Timeframe: Two hours after completion of surgery.