Background: perioperative fluid management is essential to the practice of anesthesia, notably after major operations that cause significant fluid shift, a major stress response, and altered capillary permeability. Aim: Aim of the work was to evaluate stoke volume variation (SVV) measured by electrical cardiometry as a tool to direct fluid therapy in major abdominal surgeries compared to Pleth variability index PVI measured by Masimo radical 7 apparatus guided by serum lactate level. Patients and Methods: Anesthesia, Intensive Care and Pain Management department, Faculty of Medicine - Cairo University and Theodor Bilharz Research Institute conducted this randomized comparative study. Patients undergoing significant abdominal surgery were used in the study. Results: The ICON group and the MASIMO group do not appear to differ from one another in terms of serum lactate levels, .Conclusion: The icon cardiometry performs similarly to the Masimo radical 7 in guiding Goal-Directed Fluid Therapy (GDFT), based on serum lactate level with no clinically significant differences in outcomes and offers ease of use as it can be used in either ventilated or non-ventilated patients. It has a cost benefit compared to Masimo radical 7 as it uses simple ECG electrodes, while in Masimo radical 7 a disposable expensive probes should be used.

Goal directed fluid therapy, electrical cardiometry, masimo radical7, lactate, major abdominal surgery,iconcardiometry , stoke volume variation ,pleth variability index.