Monitoring needs and goal-directed fluid therapy within an

Anesthesiology clinics · Mar 2015

Review

Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.

Patients having major abdominal surgery need perioperative fluid supplementation; however, enhanced recovery principles mitigate against many of the factors that traditionally led to relative hypovolemia in the perioperative period. An estimate of fluid requirements for abdominal surgery can be made but individualization of fluid prescription requires consideration of clinical signs and hemodynamic variables. ⋯ Application of this evidence to justify stroke volume optimization in the setting of major surgery within an enhanced recovery program is controversial. This article places the evidence in context, reviews controversies, and suggests implications for current practice and future research.

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- Gary Minto, Michael J Scott, and Timothy E Miller.
- Department of Anaesthesia & Perioperative Medicine, Plymouth Hospitals NHS Trust, Plymouth University Peninsula School of Medicine, Plymouth PL6 8DH, UK. Electronic address: gary.minto@nhs.net.
- Anesthesiol Clin. 2015 Mar 1;33(1):35-49.
AbstractPatients having major abdominal surgery need perioperative fluid supplementation; however, enhanced recovery principles mitigate against many of the factors that traditionally led to relative hypovolemia in the perioperative period. An estimate of fluid requirements for abdominal surgery can be made but individualization of fluid prescription requires consideration of clinical signs and hemodynamic variables. The literature supports goal-directed fluid therapy. Application of this evidence to justify stroke volume optimization in the setting of major surgery within an enhanced recovery program is controversial. This article places the evidence in context, reviews controversies, and suggests implications for current practice and future research.Copyright © 2015 Elsevier Inc. All rights reserved.

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Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.

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