Bisgaard J, Madsen R, Dybdal LL, et al. - Via performing a randomized controlled double blinded trial, researchers sought to test the hypothesis that intra-operative goal-directed therapy (GDT) with bolus human albumin 5% is superior to GDT with bolus ringer acetate in maintaining systemic oxygen delivery index and mesenteric oxygen delivery index in elective major upper gastrointestinal cancer surgery. They randomized 89 adults scheduled for elective major upper gastrointestinal cancer surgery to intra-operative GDT with either bolus human albumin or ringer acetate 250 ml, guided by pulse pressure variation and stroke volume. Analysis was done on data from 60 of these patients. Outcomes suggested no superiority of bolus human albumin 5% vs bolus ringer acetate in maintaining systemic or mesenteric oxygen delivery in elective major upper gastrointestinal cancer surgery, despite the administration of larger volumes of trial fluid in the ringer acetate group. They indicated no significant difference in fluid-related complications or LOS.