State-of-the-art fluid management in the operating room.


Journal Article (Review)

The underlying principles guiding fluid management in any setting are very simple: maintain central euvolemia, and avoid salt and water excess. However, these principles are frequently easier to state than to achieve. Evidence from recent literature suggests that avoidance of fluid excess is important, with excessive crystalloid use leading to perioperative weight gain and an increase in complications. A zero-balance approach aimed at avoiding fluid excess is recommended for all patients. For major surgery, there is a sizeable body of evidence that an individualized goal-directed fluid therapy (GDFT) improves outcomes. However, within an Enhanced Recovery program only a few studies have been published, yet so far GDFT has not achieved the same benefit. Balanced crystalloids are recommended for most patients. The use of colloids remains controversial; however, current evidence suggests they can be beneficial in intraoperative patients with objective evidence of hypovolemia.

Full Text

Duke Authors

Cited Authors

  • Miller, TE; Raghunathan, K; Gan, TJ

Published Date

  • September 2014

Published In

Volume / Issue

  • 28 / 3

Start / End Page

  • 261 - 273

PubMed ID

  • 25208961

Pubmed Central ID

  • 25208961

Electronic International Standard Serial Number (EISSN)

  • 1878-1608

Digital Object Identifier (DOI)

  • 10.1016/j.bpa.2014.07.003


  • eng

Conference Location

  • Netherlands