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Perioperative fluid management for major elective surgery.

N Heming1,2, P Moine1,2, R Coscas3,4

  • 1General Intensive Care Unit, Raymond PoincarĂ© Hospital, GHU APHP University Paris-Saclay, Garches, France.

The British Journal of Surgery
|January 7, 2020
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Summary
This summary is machine-generated.

Maintaining adequate fluid balance during surgery is crucial for reducing patient morbidity. Goal-directed therapy and balanced crystalloids are recommended for perioperative fluid management in major elective surgery.

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Area of Science:

  • Anesthesiology
  • Surgical Care
  • Critical Care Medicine

Background:

  • Perioperative fluid balance is critical for minimizing morbidity in patients undergoing major elective surgery.
  • Current concepts in fluid management are essential for optimizing surgical outcomes.

Purpose of the Study:

  • To review current concepts of fluid management in major elective surgery.
  • To examine the role of fluid therapy in perioperative hemodynamic management.

Main Methods:

  • A narrative review of English language reports published before July 2019.
  • Literature search using keywords including 'surgery', 'fluid therapy', 'colloids', 'crystalloids', and 'goal directed therapy'.

Main Results:

  • Fluid therapy is central to hemodynamic management during major elective surgery.
  • Both fluid overload and hypovolemia are detrimental in the perioperative phase.
  • Goal-directed therapy is recommended for individualized hemodynamic management in high-risk patients.

Conclusions:

  • Perioperative fluid management presents a significant challenge in major surgery.
  • Individualized volume optimization using goal-directed therapy is indicated for high-risk patients.
  • Balanced crystalloids are generally the preferred intraoperative fluid choice; further research on optimal fluid types is needed.