Perioperative Fluid Management in Colorectal Surgery: Institutional Approach to Standardized Practice

The present review discusses restrictive perioperative fluid protocols within enhanced recovery after surgery (ERAS) pathways. Standardized definitions of a restrictive or liberal fluid regimen are lacking since they depend on conflicting evidence, institutional protocols, and personal preferences....

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Bibliographic Details
Published inJournal of clinical medicine Vol. 13; no. 3; p. 801
Main Authors Deslarzes, Philip, Jurt, Jonas, Larson, David W, Blanc, Catherine, Hübner, Martin, Grass, Fabian
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 30.01.2024
Subjects
Clinical medicine
Clinical trials
Colorectal surgery
Complications and side effects
Disease prevention
Edema
Evidence-based medicine
Fluid mechanics
Fluids
Health aspects
Homeostasis
Hypotension
Ischemia
Laparoscopy
Meta-analysis
Morbidity
Patient outcomes
Patients
Physiology
Recovery (Medical)
Surveillance
Switzerland
perioperative
fluid management
enhanced recovery
guidance
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Summary:The present review discusses restrictive perioperative fluid protocols within enhanced recovery after surgery (ERAS) pathways. Standardized definitions of a restrictive or liberal fluid regimen are lacking since they depend on conflicting evidence, institutional protocols, and personal preferences. Challenges related to restrictive fluid protocols are related to proper patient selection within standardized ERAS protocols. On the other hand, invasive goal-directed fluid therapy (GDFT) is reserved for more challenging disease presentations and polymorbid and frail patients. While the perfusion rate (mL/kg/h) appears less predictive for postoperative outcomes, the authors identified critical thresholds related to total intravenous fluids and weight gain. These thresholds are discussed within the available evidence. The authors aim to introduce their institutional approach to standardized practice.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13030801