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Perioperative Goal-Directed Fluid Therapy: A Prime Component of Enhanced Recovery After Surgery
Nina McLain1, Stephanie Parks2, Mary Jane Collins3
1earned her PhD from Virginia Commonwealth University in Richmond, Virginia, in 2007. She has served as faculty at Samford University in Homewood, Alabama, and is currently the Nurse Anesthesia Program administrator at The University of Southern Mississippi (USM) in Hattiesburg, Mississippi.
Abstract:
Perioperative goal-directed fluid therapy (GDFT) is a prime component of the Enhanced Recovery After Surgery (ERAS) protocol. Multiple studies have demonstrated a relationship between GDFT and positive patient outcomes, including shorter hospital stays, decreased ileus formation, reduced gastrointestinal-related issues, decreased nausea, and hemodynamic stability. Electrolyte disturbances following a positive fluid balance may occur, and GDFT is aimed at euvolemia to avoid a hypervolemic state. Carbohydrate loading, early discontinuation of postoperative intravenous fluids, and use of isoosmotic solutions all are components of GDFT. Lactated Ringer's solution is the fluid recommended for nonrenal patients and patients with hepatic compromise. The negative consequences associated with hypervolemia deem it pertinent to devise an individualized GDFT plan in the ERAS protocol.
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