Perioperative fluid therapy: a statement from the international Fluid Optimization Group.
Abstract
BACKGROUND: Perioperative fluid therapy remains a highly debated topic. Its purpose
is to maintain or restore effective circulating blood volume during the immediate
perioperative period. Maintaining effective circulating blood volume and pressure
are key components of assuring adequate organ perfusion while avoiding the risks associated
with either organ hypo- or hyperperfusion. Relative to perioperative fluid therapy,
three inescapable conclusions exist: overhydration is bad, underhydration is bad,
and what we assume about the fluid status of our patients may be incorrect. There
is wide variability of practice, both between individuals and institutions. The aims
of this paper are to clearly define the risks and benefits of fluid choices within
the perioperative space, to describe current evidence-based methodologies for their
administration, and ultimately to reduce the variability with which perioperative
fluids are administered. METHODS: Based on the abovementioned acknowledgements, a
group of 72 researchers, well known within the field of fluid resuscitation, were
invited, via email, to attend a meeting that was held in Chicago in 2011 to discuss
perioperative fluid therapy. From the 72 invitees, 14 researchers representing 7 countries
attended, and thus, the international Fluid Optimization Group (FOG) came into existence.
These researches, working collaboratively, have reviewed the data from 162 different
fluid resuscitation papers including both operative and intensive care unit populations.
This manuscript is the result of 3 years of evidence-based, discussions, analysis,
and synthesis of the currently known risks and benefits of individual fluids and the
best methods for administering them. RESULTS: The results of this review paper provide
an overview of the components of an effective perioperative fluid administration plan
and address both the physiologic principles and outcomes of fluid administration.
CONCLUSIONS: We recommend that both perioperative fluid choice and therapy be individualized.
Patients should receive fluid therapy guided by predefined physiologic targets. Specifically,
fluids should be administered when patients require augmentation of their perfusion
and are also volume responsive. This paper provides a general approach to fluid therapy
and practical recommendations.
Type
Journal articlePermalink
https://hdl.handle.net/10161/12554Published Version (Please cite this version)
10.1186/s13741-015-0014-zPublication Info
Navarro, Lais Helena Camacho; Bloomstone, Joshua A; Auler, Jose Otavio Costa; Cannesson,
Maxime; Rocca, Giorgio Della; Gan, Tong J; ... Kramer, George C (2015). Perioperative fluid therapy: a statement from the international Fluid Optimization
Group. Perioper Med (Lond), 4. pp. 3. 10.1186/s13741-015-0014-z. Retrieved from https://hdl.handle.net/10161/12554.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Timothy Ellis Miller
Professor of Anesthesiology
Clinical and research interests are Enhanced Recovery and Perioperative Medicine;
with particular interests in fluid management, and perioperative optimization of the
high-risk non-cardiac surgery patient.

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