Severe and persistent morphine-induced respiratory depression associated with ATP-Binding Cassette Subfamily B Member 1 and catechol-O-methyltransferase genetic defects

Abstract

Our data are in line with studies using single direct assessment of intravascular volume 1-3 or functional assessments. 4 Single measurements preclude detection of individual changes. We have assessed such changes and demonstrate that no clinically relevant losses in total blood volume occur. We excluded patients with conditions predisposing to hypovolaemia. They include a broad range of conditions from obvious to the very subtle than occur especially in the elderly.Our findings lay the physiological basis for current goaldirected strategies of peri-operative fluid administration that explicitly preclude initial fluid loading and significantly reduce adverse outcomes. Vice versa, our data show that preventive administration of large volumes of intravenous fluids during induction of general anaesthesia to compensate for erroneously presumed fluid losses lack scientific reason.