Perioperative Fluid and Volume Management: Physiological Basis, Tools and Strategies

Overview

Journal Ann Intensive Care

Specialty Critical Care

Date 2011 Sep 13

PMID 21906324

Citations 30

Authors

Mike S Strunden

Kai Heckel

Alwin E Goetz

Daniel A Reuter

Affiliations

Soon will be listed here.

Abstract

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.

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