The effect of 'goal directed' fluid management during gynaecological oncology surgery using the oesophageal Doppler probe

INTERVENTION: Two groups: control and protocol group. Both groups will have DP6 Doppler probe (product code 9070‐7001) inserted at the time of intubation. All patients will have standard pre‐operative, intra‐operative and post‐operative care. Fluids (crystalloid, colloid and blood/blood products) will be given at the discretion of the anaesthetist, guided by standard haemodynamic monitoring and operative losses. Only the protocol group will have direct measurement of central vascular flow using CardioQ‐ODM monitor (product code 9051‐7056) including corrected flow time (FTc), stroke volume (SV), stroke distance (SD) and peak velocity (PV) and small colloid (fluid) challenges to maintain FTc greater than 0.35 seconds and optimise SV. The intervention will last until the end of the operation and the probe will be removed at the time of extubation. CONDITION: Gynaecological oncology surgery ; Surgery ; Surgical recovery PRIMARY OUTCOME: The aim of this study is to compare the effect of a target driven intra‐operative intravenous fluid management using oesophageal Doppler to a standard fluid regimen on complication rate after surgery for corpus uteri, ovarian and cervical cancer. Measured until 5th post‐operative day. SECONDARY OUTCOME: To evaluate the effect of target driven intra‐operative fluid management using oesophageal Doppler on hospital stay, measured on day of discharge. INCLUSION CRITERIA: 1. Patients aged 20 ‐ 85 years, female 2. Recruited from the Queen Elizabeth Hospital, Gateshead 3. Written informed consent 4. Undergoing elective major gynaecological oncology surgery for ovarian, endometrial and cervical carcinoma