Assessment of Fluid Responsiveness based on Starling® Noninvasive Cardiac Output Monitoring in Oncological Surgery: A Prospective Observational Study

monitoring system in adult patients aged above 18 years of age who were scheduled to undergo major open/robotic oncosurgical procedures. Materials a n d MethodsIn a observational study design, we included adult patients aged above 18 years of age who were scheduled to undergo major open/robotic oncosurgical procedures between January 2023 and December 2025 (Fig. 1).The monitor used in the study is a introduction Patients undergoing oncological surgeries present significant challenges to anesthesiologists due to various factors that include the primary pathology, the effects of chemotherapy and radiotherapy, cachexia, hypoalbuminemia, and preexisting comorbidities.Major oncological surgeries are typically prolonged, involve substantial fluid shifts and blood loss, and often require resuscitation with significant volumes of intravenous fluids, which may be combined with the use of inotropes or vasopressors.In the event of hypotension and decreased systemic perfusion, the anesthesiologist's initial response is usually to administer intravenous fluids.However, if the patient's cardiac output does not improve despite adequate fluid resuscitation, inotropic or vasopressor support is employed to stabilize their condition.Administration of intravenous fluids in the absence of demonstrable fluid responsiveness predisposes patients to iatrogenic fluid overload, with consequent increases in morbidity mediated by inflammatory activation, endothelial and glycocalyx disruption, and accumulation of extravascular lung water. 1 Such indiscriminate fluid therapy may precipitate clinically significant complications, including decompensated heart failure and acute deterioration in renal function, particularly in patients with preexisting cardiac or renal disease.This study aims to determine the effectiveness of Starling noninvasive cardiac output 1,