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Perioperative fluid therapy: A statement from the international Fluid Optimization Group

Navarro, LHC and Bloomstone, JA and Auler, JOC and Cannesson, M and Rocca, GD and Gan, TJ and Kinsky, M and Magder, S and Miller, TE and Mythen, M and Perel, A and Reuter, DA and Pinsky, MR and Kramer, GC (2015) Perioperative fluid therapy: A statement from the international Fluid Optimization Group. Perioperative Medicine, 4 (1).

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Abstract

© 2015 Navarro et al.; licensee BioMed Central. Background: Perioperative fluid therapy remains a highly debated topic. Its purpose is to maintain or restore effective circulating blood volume during the immediate perioperative period. Maintaining effective circulating blood volume and pressure are key components of assuring adequate organ perfusion while avoiding the risks associated with either organ hypo- or hyperperfusion. Relative to perioperative fluid therapy, three inescapable conclusions exist: overhydration is bad, underhydration is bad, and what we assume about the fluid status of our patients may be incorrect. There is wide variability of practice, both between individuals and institutions. The aims of this paper are to clearly define the risks and benefits of fluid choices within the perioperative space, to describe current evidence-based methodologies for their administration, and ultimately to reduce the variability with which perioperative fluids are administered.Methods: Based on the abovementioned acknowledgements, a group of 72 researchers, well known within the field of fluid resuscitation, were invited, via email, to attend a meeting that was held in Chicago in 2011 to discuss perioperative fluid therapy. From the 72 invitees, 14 researchers representing 7 countries attended, and thus, the international Fluid Optimization Group (FOG) came into existence. These researches, working collaboratively, have reviewed the data from 162 different fluid resuscitation papers including both operative and intensive care unit populations. This manuscript is the result of 3 years of evidence-based, discussions, analysis, and synthesis of the currently known risks and benefits of individual fluids and the best methods for administering them.Results: The results of this review paper provide an overview of the components of an effective perioperative fluid administration plan and address both the physiologic principles and outcomes of fluid administration.Conclusions: We recommend that both perioperative fluid choice and therapy be individualized. Patients should receive fluid therapy guided by predefined physiologic targets. Specifically, fluids should be administered when patients require augmentation of their perfusion and are also volume responsive. This paper provides a general approach to fluid therapy and practical recommendations.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Navarro, LHC
Bloomstone, JA
Auler, JOC
Cannesson, M
Rocca, GD
Gan, TJ
Kinsky, M
Magder, S
Miller, TE
Mythen, M
Perel, A
Reuter, DA
Pinsky, MRpinsky@pitt.eduPINSKY
Kramer, GC
Date: 10 April 2015
Date Type: Publication
Journal or Publication Title: Perioperative Medicine
Volume: 4
Number: 1
DOI or Unique Handle: 10.1186/s13741-015-0014-z
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
Date Deposited: 31 Aug 2016 17:25
Last Modified: 21 Mar 2018 16:55
URI: http://d-scholarship.pitt.edu/id/eprint/29379

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