Influence of central venous pressure reducing manouvres on the postoperative outcome in patients undergoing major liver surgery

Comparison of two strategies of reaching low central venous pressure (Low-CVP; below 5 mmHg) during liver resection surgery. One strategy is using absolute fluid restriction (Arm 1 - intervention), the other one relative volume redistribution caused by systemic vasodilation (Arm 2 - control). Treatments in both groups will be administered by treating anaesthesiologist (member of the study team) according to the randomization during the preoperative (from morning till surgery) and intraoperative period. Treatments in both arms will be graded into predefined steps. In the Arm 1 absolute restriction of circulating volume will be provided by reduction of preoperative fluids (neither intravenous nor oral intake 6 hours prior surgery) coupled with minimal (1ml/kg/hour, Ringerfundin solution - B´Braun) intraoperative intravenous supplementation. If needed, given the CVP value assessed by the treating anaesthesiologist, diuretics will be further administered (Furosemide 10mg intravenous per step, maximum 3 doses allowed i.e. up to three steps) to reach the low-CVP target. Participants will receive only the minimal number of steps required to reach the 5mmHg CVP target.