American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery.
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BACKGROUND: Enhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There is some controversy about the adoption of specific elements in enhanced recovery "bundles" because the relative importance of different components of ERPs is hard to discern (a consequence of multiple simultaneous changes in clinical practice when ERPs are initiated). There is evidence that specific approaches to fluid management are better than alternatives in patients undergoing colorectal surgery; however, several specific questions remain. METHODS: In the "Perioperative Quality Initiative (POQI) Fluids" workgroup, we developed a framework broadly applicable to the perioperative management of intravenous fluid therapy in patients undergoing elective colorectal surgery within an ERP. DISCUSSION: We discussed aspects of ERPs that impact fluid management and made recommendations or suggestions on topics such as bowel preparation; preoperative oral hydration; intraoperative fluid therapy with and without devices for goal-directed fluid therapy; and type of fluid.
Enhanced recovery pathway
Goal-directed fluid therapy
Published Version (Please cite this version)10.1186/s13741-016-0049-9
Publication InfoBrudney, CS; Cannesson, M; Gan, Tong Joo; Lobo, DN; Martin, D; Miller, Timothy Ellis; ... Thiele, RH (2016). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery. Perioper Med (Lond), 5. pp. 24. 10.1186/s13741-016-0049-9. Retrieved from https://hdl.handle.net/10161/13929.
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Consulting Professor in the Department of Anesthesiology
My current research interests include postoperative nausea and vomiting (PONV), acute postoperative pain, clinical pharmacology of anesthetic drugs and resuscitation fluids as well as database research in postoperative outcomes. Improving Outcome in Surgical Patients: Nausea and vomiting is regarded as one of the most unpleasant experiences in postoperative recovery. To date, there is no single antiemetic which can satisfactorily control PONV. My interests concentrate o
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Associate 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.
Adjunct Professor in the Department of Anesthesiology
Main area of research interest is the role of gut mucosal hypoperfusion in the pathogenesis of post-operative organ dysfunction. On-going projects include: i) the effects of temperature on gut perfusion during cardiopulmonary by-pass, ii) the relationship between cerebral and splanchnic hypoperfusion during cardiac surgery, iii) the relationship between gut mucosal hypoperfusion and outcome in patients admitted for surgical intensive care, iv) the effects of enteral feeding on gut perfusion and
Associate Professor of Anesthesiology
Dr. Karthik Raghunathan, MD is a board certified anesthesiologist affiliated with Duke University and with the Durham Veterans Affairs Healthcare System in Durham, North Carolina.
Adjunct Associate Professor in the Department of Anesthesiology
Dr Shaw is an Associate Professor of Anesthesiology and Critical Care Medicine at Duke University Medical Center. He is a Fellow of the Royal College of Anaesthetists (UK) and a Fellow of the American College of Critical Care Medicine. He has practiced cardiothoracic anesthesiology and critical care medicine for more than 15 years in the UK and USA, has authored 3 textbooks and more than 100 original papers. He currently runs the iPEGASUS initiative, an international surgical outcomes conso
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