Perioperative fluid and volume management: physiological basis, tools and strategies

Fluid and volume therapy is an important cornerstone of treating critically ill patients in the intensive care unit and in the operating room. New findings concerning the vascular barrier, its physiological functions, and its role regarding vascular leakage have lead to a new view of fluid and volum...

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Bibliographic Details
Published in:Annals of intensive care 2011-03, Vol.1 (1), p.2-2, Article 2
Main Authors: Strunden, Mike S, Heckel, Kai, Goetz, Alwin E, Reuter, Daniel A
Format: Article
Language:English
Subjects:
Anesthesiology
Critical Care Medicine
Emergency Medicine
Intensive
Intensive care
Medicine
Medicine & Public Health
Review
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Summary:Fluid and volume therapy is an important cornerstone of treating critically ill patients in the intensive care unit and in the operating room. New findings concerning the vascular barrier, its physiological functions, and its role regarding vascular leakage have lead to a new view of fluid and volume administration. Avoiding hypervolemia, as well as hypovolemia, plays a pivotal role when treating patients both perioperatively and in the intensive care unit. The various studies comparing restrictive vs. liberal fluid and volume management are not directly comparable, do not differ (in most instances) between colloid and crystalloid administration, and mostly do not refer to the vascular barrier's physiologic basis. In addition, very few studies have analyzed the use of advanced hemodynamic monitoring for volume management. This article summarizes the current literature on the relevant physiology of the endothelial surface layer, discusses fluid shifting, reviews available research on fluid management strategies and the commonly used fluids, and identifies suitable variables for hemodynamic monitoring and their goal-directed use.
ISSN:2110-5820
2110-5820
DOI:10.1186/2110-5820-1-2