Goal directed fluid therapy (GDT) implies administration of fluid boluses with the aim of optimizing cardiac performance. There is a major concern that maximization of cardiovascular performance can be achieved in expense of deterioration in body hydration processes. Also, these methods require semi invasive devices. However, monitoring of the whole body hydration status and interstitial fluid accumulation during fluid loading is not possible in everyday clinical practice. A new method, minimum Volume Loading Test (mVLT), uses evaluation of plasma dilution efficacy in small fluid boluses (2.5 – 5.0 ml kg-¹) of isoosmotic crystalloid solutions followed by 5 min periods without fluids. The inva-sively measured arterial and venous hemoglobins, and simultaneous non-invasively measured hemoglobin (SpHb™ from Radical-7, Masimo inc., Irvine, USA) are used for estimation of plasma dilution which serves as an indication of plasma volume expansion.
The objective of this paper was to discuss plasmadilution as a target parameter for goal directed therapy. Could plasma di-lution also indicate a degree of interstitial fluid accumulation?