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    State-of-the-art fluid management in the operating room.

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    Date
    2014-09
    Authors
    Gan, Tong Joo
    Miller, Timothy Ellis
    Raghunathan, Karthik
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    Abstract
    The underlying principles guiding fluid management in any setting are very simple: maintain central euvolemia, and avoid salt and water excess. However, these principles are frequently easier to state than to achieve. Evidence from recent literature suggests that avoidance of fluid excess is important, with excessive crystalloid use leading to perioperative weight gain and an increase in complications. A zero-balance approach aimed at avoiding fluid excess is recommended for all patients. For major surgery, there is a sizeable body of evidence that an individualized goal-directed fluid therapy (GDFT) improves outcomes. However, within an Enhanced Recovery program only a few studies have been published, yet so far GDFT has not achieved the same benefit. Balanced crystalloids are recommended for most patients. The use of colloids remains controversial; however, current evidence suggests they can be beneficial in intraoperative patients with objective evidence of hypovolemia.
    Type
    Journal article
    Subject
    colloid
    crystalloid
    fluids
    goal-directed fluid therapy
    Fluid Therapy
    Humans
    Isotonic Solutions
    Operating Rooms
    Perioperative Care
    Permalink
    https://hdl.handle.net/10161/14001
    Published Version (Please cite this version)
    10.1016/j.bpa.2014.07.003
    Publication Info
    Gan, Tong Joo; Miller, Timothy Ellis; & Raghunathan, Karthik (2014). State-of-the-art fluid management in the operating room. Best Pract Res Clin Anaesthesiol, 28(3). pp. 261-273. 10.1016/j.bpa.2014.07.003. Retrieved from https://hdl.handle.net/10161/14001.
    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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    Scholars@Duke

    Tong Joo Gan

    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.
    Miller

    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.
    Raghunathan

    Karthik Raghunathan

    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.
    Alphabetical list of authors with Scholars@Duke profiles.
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    Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy

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