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Goal-directed fluid therapy in the perioperative setting
Journal article   Open access   Peer reviewed

Goal-directed fluid therapy in the perioperative setting

Julia B. Kendrick, Alan David Kaye, Yiru Tong, Kumar Belani, Richard D. Urman, Christopher Hoffman and Henry Liu
Journal of anaesthesiology, clinical pharmacology, v 35(Suppl 1), pp S29-S34
01 Apr 2019
DOI: https://doi.org/10.4103/joacp.JOACP_26_18
PMID: 31142956
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.4103/joacp.joacp_26_18View
Published, Version of Record (VoR)CC BY-NC-SA V4.0,  Open
url
https://doi.org/10.4103/joacp.JOACP_26_18View
Published, Version of Record (VoR) Open

Abstract

Arterial contour analysis bioimpedance ERAS goal-directed therapy length of hospital stay Review volume status
Improvement in patient outcomes has become a significant consideration with our limited resources in the surgical setting. The implementation of enhanced recovery pathway protocols has resulted in significant benefits to both the patients and hospitals, such as shorter length of hospital stays, reduction in the rate of complications, and fewer hospital readmissions. An emerging component and a key element for the success of Enhanced Recovery After Surgery (ERAS) protocols has been the concept of goal-directed fluid therapy (GDT). GDT related to ERAS protocols attempts to minimize complications associated with fluid imbalance during surgery. We performed a literature search for articles that included the terms enhanced recovery and GDT. We evaluated methods for appropriate volume status assessment, such as heart rate, blood pressure, end-tidal CO 2 , central venous pressure, urine output, stroke volume, cardiac output, and their derivatives. Some invasive, minimally invasive, and non-invasive monitors of hemodynamic evaluation are now being used to assess volume status and predict fluid responsiveness and fluid need during various surgical procedures. Regardless of monitoring technique, it is important for the clinician to effectively plan and implement preoperative and intraoperative fluid goals. Excess crystalloid fluid should be avoided. In some low-risk patients undergoing low-risk surgery, a “zero-balance” approach is encouraged. For the majority of patients undergoing major surgery, GDT is recommended. Optimal perioperative fluid management is an important component of the ERAS pathways and it can reduce postoperative complications.

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84 citations in Web of Science
101 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Pharmacology & Pharmacy
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