“When in Doubt, Give Fluids and Kill Your Patient”. | [Anaesthesia, Pain and Intensive Care • 2018]

Author(s):

1. Xavier Falieres: Albert Schweitzer Hospital, Albert Schweitzerplaats 25, NL-3318AT, Dordrecht, (The Netherlands)

Abstract:

The art of giving the correct amount of intravenous fluids is a very important part of anesthetic management. Intraoperative liberal fluid management during surgery, particularly during major abdominal surgery, has been the golden standard until the beginning of the 21st century. Recent studies and insights have shifted our fluid management towards a more conservative regimen. However, due to conflicting conclusions, heterogeneous studies and a variety of existing fluids, there is still no consensus about the optimal amount and composition to administer. This editorial will give a historical overview on fluid therapy in major abdominal surgery and the currently available evidence. The daily practice, of course, raises a number of questions, and the important ones out of these will be discussed.

Page(s): 293-296

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 22, Issue: 3, Year: 2018

Keywords:

Crystalloids , Noninvasive , Colloids , fluid therapy , Abdominal surgery , Cardiac output

References:

[1] NorthAm, 1993., 73 229 -41

[2] .with 500 ml of Hartmann's solution, -

[3] 1999.,tesiol Reanim 46 14 -8

[4] ., 44 519 -51

[5] 2001.,N Engl J Med 345 1368 -

[6] ., -

[7] J Med, 2017., 376 2223 -34

[8] 2009., 13 -

[9] PestañaD,EspinosaE,EdenA,NájeraD,CollarL,AldecoaC, 2014.Perioperative goal-directed hemodynamic optimization using noninvasive cardiac output monitoring in major abdominal surgery: a prospective, randomized, multicenter, pragmatic trial: POEMAS Study (Peri Operative goal-directed therapy in Major Abdominal Surgery),Anesth Analg 119 579 -87

[10] CecconiM, 2014.Rhodes A. Goal-directed therapy: time to move on? Anesth Analg, 119 516 -8

[11] PearseRM,HarrisonDA,MacDonaldN,GilliesMA,BluntM,AcklandG, .Effect of a perioperative, cardiac outputguided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: a randomized clinical trial and systematic review,JAMA. 2014 Jun 4 2181 -90

[12] ThackerJK,MountfordWK,ErnstFR,KrukasMR,MythenMM, 2016.Perioperative fluid utilization variability and association with outcomes,Ann Surg 263 502 -10

[13] RollinsKE,LoboDN, 2016.Intraoperative Goal-directed Fluid Therapy in Elective Major Abdominal Surgery. A Metaanalysis of Randomized Controlled Trials,Ann Surg 263 465 -76

[14] YuanJ,SunY,PanC,LiT, 2017.Goal-directed fluid therapy for reducing risk of surgical site infections following abdominal surgery - A systematic review and meta-analysis of randomized controlled trials,Int J Surg 39 74 -87

[15] MylesPS,BellomoR,CorcoranT,ForbesA,PeytonP,StoryD., .Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery,2018 Jun 378 2263 -74

[16] ShinCH,LongDR,McLeanD,GrabitzSD,LadhaK,Timm FP, 2018.Effects of intraoperative fluid management on postoperative outcomes: A hospital registry study,Ann Surg 267 1084 -92

[17] BrandstrupB. Finding, .the Right Balance,2018 Jun 378 2335 -6

[18] LewisSR,PritchardMW,EvansDJW,ButlerAR,AldersonP,SmithAF,RobertsI., 2018.Colloids versus crystalloids for fluid resuscitation in critically ill people,Cochrane Database of Systematic Reviews -

[19] European, .Hydroxyethyl starch solutions: CMDh introduces new measures to protect patients, -

[20] .6% Hetastarch in Lactated Electrolyte Injection Flexible Plastic Container, -

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