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Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.
Anesthesiol Clin. 2015 Mar; 33(1):35-49.AC

Abstract

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. 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.

Authors+Show Affiliations

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.Department of Anaesthesia and Intensive Care Medicine, Royal Surrey County Hospital, University of Surrey, Guildford GU1 7XX, UK.Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25701927

Citation

Minto, Gary, et al. "Monitoring Needs and Goal-directed Fluid Therapy Within an Enhanced Recovery Program." Anesthesiology Clinics, vol. 33, no. 1, 2015, pp. 35-49.
Minto G, Scott MJ, Miller TE. Monitoring needs and goal-directed fluid therapy within an enhanced recovery program. Anesthesiol Clin. 2015;33(1):35-49.
Minto, G., Scott, M. J., & Miller, T. E. (2015). Monitoring needs and goal-directed fluid therapy within an enhanced recovery program. Anesthesiology Clinics, 33(1), 35-49. https://doi.org/10.1016/j.anclin.2014.11.003
Minto G, Scott MJ, Miller TE. Monitoring Needs and Goal-directed Fluid Therapy Within an Enhanced Recovery Program. Anesthesiol Clin. 2015;33(1):35-49. PubMed PMID: 25701927.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Monitoring needs and goal-directed fluid therapy within an enhanced recovery program. AU - Minto,Gary, AU - Scott,Michael J, AU - Miller,Timothy E, PY - 2015/2/23/entrez PY - 2015/2/24/pubmed PY - 2015/12/15/medline KW - Cardiac output monitoring KW - Colorectal surgery KW - Enhanced recovery KW - Fluid therapy SP - 35 EP - 49 JF - Anesthesiology clinics JO - Anesthesiol Clin VL - 33 IS - 1 N2 - 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. 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. SN - 1932-2275 UR - https://www.unboundmedicine.com/medline/citation/25701927/Monitoring_needs_and_goal_directed_fluid_therapy_within_an_enhanced_recovery_program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1932-2275(14)00129-3 DB - PRIME DP - Unbound Medicine ER -