Publication
Title
Fluid management before, during and after elective surgery
Author
Abstract
Purpose of review Fluid management is regarded as a cornerstone of successful perioperative care, but fluid prescription is not always treated that way. New insights and guidelines have become available very recently. Recent findings Although most of the recent scientific attention went to resuscitation fluids and the place of hydroxyethyl starches, recent guidelines also emphasize the importance of fluid prescription in a maintenance and a replacement setting. The use of balanced solutions over saline 0.9% gains momentum because recent evidence shows the deleterious effect of chloride-containing solutions on relevant clinical endpoints. Where the debate on the use of starches in septic and critically ill patients seems to be settled after recent trials pointed out several safety issues in the absence of a proven benefit, their intraoperative use is still a matter of debate. A presumably correct use in this setting was proposed recently. Summary The combination of a careful prescription of maintenance fluids, additional replacement solutions tailored to the patient's eventual extra needs and a rational but nonaggressive goal-directed approach to resuscitation fluids seems to be the best practice to avoid fluid-related morbidity. Isotonic balanced crystalloids seem the best pragmatic choice for resuscitation purposes. In certain well defined conditions, colloids can still be used.
Language
English
Source (journal)
Current opinion in critical care. - Philadelphia, Pa
Publication
Philadelphia, Pa : 2014
ISSN
1070-5295
Volume/pages
20:4(2014), p. 390-395
ISI
000338725400007
Full text (Publisher's DOI)
UAntwerpen
Faculty/Department
Research group
[E?say:metaLocaldata.cgzprojectinf]
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 08.09.2014
Last edited 13.10.2017
To cite this reference