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Intraoperative fluid management

Author
Girish P Joshi, MB, BS, MD, FFARCSI
Section Editor
Michael Avidan, MD
Deputy Editor
Nancy A Nussmeier, MD, FAHA

INTRODUCTION

Perioperative maintenance of adequate intravascular volume status is important to achieve optimal outcomes after surgery, but there are controversies regarding both composition and volume of intraoperative fluid therapy. This topic will review derangements and monitoring of intravascular volume status in this setting, as well as strategies for choosing appropriate composition, amount, and timing of intraoperative fluid administration.

Severe intravascular volume depletion in surgical patients is discussed in other topics. (See "Intraoperative management of shock in adults", section on 'Hypovolemic shock management' and "Massive blood transfusion".)

Routine management of maintenance and replacement fluids in nonsurgical settings is discussed separately. (See "Maintenance and replacement fluid therapy in adults".)

CONSEQUENCES OF INTRAVASCULAR VOLUME DERANGEMENTS

Maintenance of intravascular euvolemia throughout the perioperative period is ideal. Both hypovolemia and hypervolemia are associated with postoperative morbidity [1-3].

Hypovolemia — Absolute or relative hypovolemia is common in the perioperative period due to preoperative dehydration, vasodilation caused by anesthetic and adjuvant drugs, and surgical bleeding. (See 'Causes of intravascular volume derangements' below.)

                             
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Literature review current through: Oct 2017. | This topic last updated: Nov 09, 2017.
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