Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.
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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.
SubjectCardiac output monitoring
Published Version (Please cite this version)10.1016/j.anclin.2014.11.003
Publication InfoMinto, Gary; Scott, Michael J; & Miller, Timothy E (2015). Monitoring needs and goal-directed fluid therapy within an enhanced recovery program. Anesthesiol Clin, 33(1). pp. 35-49. 10.1016/j.anclin.2014.11.003. Retrieved from https://hdl.handle.net/10161/13996.
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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.