Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.
Abstract
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.
Type
Journal articleSubject
Cardiac output monitoringColorectal surgery
Enhanced recovery
Fluid therapy
Abdomen
Cardiac Output
Fluid Therapy
Goals
Humans
Hypovolemia
Monitoring, Intraoperative
Needs Assessment
Perioperative Care
Postoperative Complications
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https://hdl.handle.net/10161/13996Published Version (Please cite this version)
10.1016/j.anclin.2014.11.003Publication Info
Minto, G; Scott, MJ; & Miller, Timothy Ellis (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.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
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.

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