Fluid therapy might be more difficult than you think.

@article{Hahn2007FluidTM,
  title={Fluid therapy might be more difficult than you think.},
  author={Robert G. Hahn},
  journal={Anesthesia and analgesia},
  year={2007},
  volume={105 2},
  pages={
          304-5
        }
}
  • R. Hahn
  • Published 1 August 2007
  • Medicine
  • Anesthesia and analgesia
Robert G. Hahn, MD, PhD Young anesthesiologists have long been taught that the replacement of losses is the key target in the management of IV fluid therapy. During surgery, a fluid deficit is undoubtedly created by preoperative fasting, surgical blood loss, evaporation, and urinary excretion. The vasodilatation induced by many forms of anesthesia allows the vascular space to contain more plasma, and this additional volume should probably be provided as IV fluid. Many of us feel encouraged to… Expand
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References

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Liberal Versus Restrictive Fluid Management in Knee Arthroplasty: A Randomized, Double-Blind Study
TLDR
A liberal compared to a restrictive intravascular fluid regimen may lead to significant hypercoagulability and a reduction in vomiting, but without differences in other recovery variables or hospital stay after fast-track knee arthroplasty. Expand
Liberal Versus Restrictive Fluid Administration to Improve Recovery After Laparoscopic Cholecystectomy: A Randomized, Double-Blind Study
TLDR
Nausea, general well-being, thirst, dizziness, drowsiness, fatigue, and balance function were significantly improved, as well as significantly more patients fulfilled discharge criteria and were discharged on the day of surgery with the high-volume fluid substitution. Expand
Effect of Intraoperative Fluid Management on Outcome after Intraabdominal Surgery
TLDR
In patients undergoing elective intraabdominal surgery, intraoperative use of restrictive fluid management may be advantageous because it reduces postoperative morbidity and shortens hospital stay. Expand
Intravascular Fluid Administration and Hemodynamic Performance During Open Abdominal Surgery
TLDR
Half of the patients undergoing open abdominal surgery responded to crystalloid fluid with a decrease in cardiac output, which can be simulated for various fluid regimens using volume kinetics. Expand
Goal-directed Intraoperative Fluid Administration Reduces Length of Hospital Stay after Major Surgery
TLDR
Goal-directed intraoperative fluid administration results in earlier return to bowel function, lower incidence of postoperative nausea and vomiting, and decrease in length of postoperatively hospital stay. Expand
The Volume Kinetics of Acetated Ringer’s Solution During Laparoscopic Cholecystectomy
TLDR
A nomogram based on the kinetic variables suggests that infusion rates should be relatively rapid early on during surgery but slower later, which creates a constant plasma dilution at any desired level without causing undue peripheral accumulation of fluid. Expand
Randomized controlled trial to investigate influence of the fluid challenge on duration of hospital stay and perioperative morbidity in patients with hip fractures.
TLDR
Invasive intraoperative haemodynamic monitoring with fluid challenges during repair of femoral fracture under general anaesthetic shortens time to being medically fit for discharge, and postoperative recovery for survivors was significantly faster. Expand
Physiologic Effects of Intravenous Fluid Administration in Healthy Volunteers
TLDR
Responses to an IV fluid infusion in healthy volunteers to assess basic physiologic effects of a fluid infusion per se may serve as a basis for clinical studies applying the same type of fluid in different amounts to determine the optimal amount of perioperative fluid in various surgical procedures. Expand
Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial.
TLDR
The restricted perioperative intravenous fluid regimen aiming at unchanged body weight reduces complications after elective colorectal resection. Expand
Stability of the interstitial matrix after crystalloid fluid loading studied by volume kinetic analysis.
TLDR
It is concluded that a fluid challenge makes elimination of further infused fluid more effective but does not change compliance with volume expansion in healthy volunteers. Expand
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