Intraoperative Fluid Management

Thompson, Judy

doi:10.1016/j.cnc.2014.10.012

Cited by 5 publications

(9 citation statements)

References 14 publications

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“…In 1957, Holliday and Segar created an hourly fluid management protocol based on the patients' weight in kilograms (kg) entitled the '4-2-1 rule-,' it has been accepted and used widely ever since in the operating room (OR) (Thompson, 2015). The foundation of their work centered on the knowledge that a healthy adult must intake a sufficient amount of water to balance gastrointestinal, urinary and insensible losses throughout the day (Thompson).…”

Section: Methods Of Managing Intra-operative Fluidsmentioning

confidence: 99%

“…Some methods will also be further explained in the following paragraphs. With neuraxial/regional anesthesia: 10mL/kg; without neuraxial/regional anesthesia 5-7mL/kg (Adapted from Gallagher & Vacchiano, 2015) Another methodology came about years later called the 'NPO deficit' which is still used today (Thompson, 2015). Risks for hypovolemia and dehydration increase the longer the patient has been NPO.…”

Section: -20kgmentioning

confidence: 99%

“…Judy Thompson (2015) explained the basics of fluid management along with current fluid management practices. The human body is made up of a high percentage of water and consists of two different fluid compartments deemed intracellular (ICF) and extracellular (ECF).…”

Section: Intra-operative Fluid Administrationmentioning

confidence: 99%

“…New advances in technology and a recent growing trend in the literature is the utilization of goal-directed fluid therapy. Goal directed therapy utilizes non-invasive and/or invasive monitoring techniques to help the nurse anesthetist guide fluid administration in real time based on the patients stroke volume trends (Thompson, 2015). The most common method of monitoring stroke volume is use of the esophageal Doppler-a probe placed into the patient's esophagus after induction of anesthesia (Schober, Loer, & Schwarte, 2009).…”

Section: Background/statement Of the Problemmentioning

confidence: 99%

“…In Table 1 on the next page is a list of the impact of hypervolemia and hypovolemia to the body. Table 1 Clinical manifestations of hypervolemia and hypovolemia There are two different types of intravenous (IV) fluids given to treat different types of fluid and electrolyte imbalances, colloid and crystalloid (Thompson, 2015).…”

Section: Intra-operative Fluid Administrationmentioning

confidence: 99%

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Intra-Operative IV Fluid Management: Goal Directed Therapy with Esophageal Doppler Monitoring vs. Standard Weight Based Fluid Therapy

Krueger¹

2016

Preprint

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Intravenous fluid management in the peri-operative period continues to be a debate in the anesthesia literature in terms of which fluid type is best along with how much fluid should be given. The majority of post-operative complications in colo-rectal surgery can be traced back to the amount of IV fluids patients receive. Most recently the term Goaldirected therapy (GDT) states that a more individualized approach to fluid management is not only safer but necessary. The Esophageal Doppler, a technology analyzing stroke volume and cardiac output intra-operative, may prove to be a safe way to provide GDT and decrease complications post-operatively. This systematic review examined the impact of the esophageal Doppler versus the traditional weight based fluid management technique on adult (>18 years of age) patient outcomes post-operatively after colo-rectal and abdominal surgery. The goal was to highlight best practices that will decrease adverse patient events and length of stay (LOS). Four out of the five randomized controlled trials analyzed for this review do report that ED use and GDT decrease complications and ICU admissions post-operatively versus utilizing a more standard approach to fluid management. Due to other social variables in discharging subjects, length of stay was not found to be decreased in GDT subject groups. In furthering anesthesia practice, standard fluid management techniques should be updated with a more individualized approach focusing on patient variables such as stroke volume and what the response is to fluid therapy intra-operatively.

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Section: Methods Of Managing Intra-operative Fluidsmentioning

confidence: 99%

Section: -20kgmentioning

confidence: 99%

Section: Intra-operative Fluid Administrationmentioning

confidence: 99%

Section: Background/statement Of the Problemmentioning

confidence: 99%

Section: Intra-operative Fluid Administrationmentioning

confidence: 99%

See 3 more Smart Citations