Fluıd Treatment Methods Implemented in Perioperative Periods

Yıl 2017, Cilt: 4 Sayı: 1, 50 - 56, 08.02.2017

Perihan Şimşek , Dilek Çilingir

https://doi.org/10.17681/hsp.285894

Öz

Ensuring adequate fluid therapy
in the perioperative period have a significant role on meeting the increased
metabolic requirements and the prevention of postoperative complications. In
general fluid treatment methods called as restrictive or liberal have been implemented
for maintaining fluid balance in the perioperative period. These methods are
based on calculation of the known or estimated fluid loss. In recent researches
have shown that  implemented fluid
therapy according to these methods may be excessive or insufficient and  may cause problems like fluid loading and
hypovolemia. Today to avoid all these
problems, individual goal directed fluid therapy is recommended in
perioperative period. In individual goal directed fluid therapy amount and type
of fluid to be applied have been selected  cosidering 
individual characteristics of patients and treatment have been implemented
under the guidance of determined hemodynamic criteria. In this article,
information concerning the implemented fluid treatment methods for surgical
patients in the perioperative period is presented.

Anahtar Kelimeler

Perioperative period, surgery patient, monitoring

Ameliyat Sürecinde Uygulanan Sıvı Tedavisi Yöntemleri

Öz

Ameliyat sürecini kapsayan dönemde uygun sıvı
tedavisinin sağlanması, artan metabolik gereksinimlerin karşılanması ve
ameliyat sonrası dönemde komplikasyonların önlenmesinde önemli role sahiptir.
Genel olarak ameliyat sürecinde sıvı dengesinin sürdürülebilmesi için serbest
ya da kısıtlayıcı olarak adlandırılan sıvı tedavisi yöntemleri uygulanmaktadır.
Bu yöntemler, bilinen ya da tahmin edilen sıvı kayıplarının hesaplanması ve
karşılanması esasına dayanmaktadır. Son yıllarda yapılan çalışmalar, bu
yöntemlere göre uygulanan sıvı tedavilerinin aşırı ya da yetersiz olabildiğini
ve sıvı yüklemesi ya da hipovolemi gibi sorunlara neden olabildiğini göstermektedir.
Günümüzde tüm bu sorunların önlenebilmesi için ameliyat sürecini kapsayan
dönemde bireye özgü hedefe yönelik sıvı tedavisi önerilmektedir. Bireye özgü
hedefe yönelik sıvı tedavisinde uygulanacak sıvının miktarı ve cinsi hastaların
bireysel özellikleri dikkate alınarak seçilmekte ve tedavi belirlenen hemodinamik
ölçütlerin rehberliğinde uygulanmaktadır. Bu makalede, ameliyat sürecini
kapsayan dönemde uygulanan sıvı tedavisi yöntemlerine ilişkin bilgi
sunulmaktadır

Anahtar Kelimeler

Ameliyat süreci, cerrahi hasta, izlem

Kaynakça

• 1. P. Van Der Linden. Volume optimization in surgical patients Wet or Dry? Acta Anaesthesiologica Belgica 2007;58:245-250.
• 2. Kayilioglu SI, Dinç T, Sozen İ, Bostanoglu A, Cete M, Coskun F. Postoperative fluid management. World Journal Critical Care Medicine 2015; 4(3):192-201.
• 3. Navarro LHC, Bloomstone JA, Auler Jr JOC, Cannesson M, Rocca GD, Gan TJ, et. al. Perioperative fluid therapy: a statement from the international fluid optimization group. Perioperative Medicine 2015;4(3):1-20.
• 4. Kehlet H, Bundgaard-Nielsen M. Goal-directed perioperative fluid management. Anesthesiology 2009;110:453-455.
• 5. Minto G, Mythen MG. Perioperative fluid management: Science, art or random chaos? British Journal of Anaesthesia 2015;114(5):717-721.
• 6. Rocca GD, Vetrugno L, Tripi G, Deana C, Barbariol F, Pompei L. Liberal or restricted fluid administration: are we ready for a proposal of a restricted intraoperative approach? Bio Medical Central Anesthesiology 2014;14:62.
• 7. Lamke LO, Nilsson GE, Reithner HL. Water loss by evaporation from the abdominal cavity during surgery. Acta Chirurgica Scandinavica 1977;143:279-284.
• 8. Strunden MS, Heckel K, Goetz AE, Reuter DA. Perioperative fluid and volume management: physiological basis, tools and strategies. Annals of Intensive Care 2011;1(1):2
• 9. Jacob M, Chappell D, Rehm M. The “third space”—fact or fiction? Best Practice & Research Clinical Anaesthesiology 2009;23(2):145-157.
• 10. Holte K. Pathophysiology and clinical implications of peroperative fluid management in elective surgery. Danish Medical Bulletin 2010;57(7):B4156.
• 11. Bellamy MC. Wet, dry or something else? British Journal of Anaesthesia 2006;97(6): 755-757.
• 12. Rahari Nİ, Zimmermann J, Schmidt T, Koch M, Weigand MA, Weitz J. Meta-analysis of fluid administration in colorectal surgery. British Journal of Surgery 2009;96: 331-341.
• 13. Doherty M, Buggy DJ. Intraoperative fluids: how much is too much? British Journal of Anaesthesia 2012;109(1):69-79.
• 14. Moemen ME. Fluid therapy: Too much or too little. Egyptian Journal of Anaesthesia 2010;26(4): 313-318.
• 15. Bleier JI, Aarons CB. Perioperative fluid restriction. Clinics in Colon and Rectal Surgery 2013;26(03):197-202.
• 16. Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, et.al. Guidelines for Perioperative Care in Elective Colonic Surgery: Enhance Recovery After Surgery (ERAS) Society Recommendations. World Journal of Surgery 2013;37:259-284.
• 17. Fluid Balance and Acute Kidney Injury: Potential Adverse Effects of Liberal Fluid Therapy. Medscape [Cited 7 June 2016]. Avaible from: http://www.medscape.org/viewarticle/715130_4.
• 18. Nisanveich V, Feisenstein J, Almogy G, Weissman C, Einav S, Matot I. Effect of intraoperative fluid management on outcome after intraabdominal surgery. Anesthesiology 2005;103:25-32.
• 19. Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. Journal of The American Medical Association 2012;308:1566-1572.
• 20. Woldby AW, Brandstrup B. Fluid therapy in the perioperative setting a clinical review. Journal of Intensive Care 2016;4:27.
• 21. Lambert KG, Wakim JH, Lambert NE. Preoperative fluid bolus and reduction of postoperative nausea and vomiting in patients undergoing laparoscopic gynecologic surgery. American Association of Nurse Anesthetists Journal 2009; 77: 110-114.
• 22. Zhang J, Qiao H, He Z, Wang Y, Che X, Liang W. Intraoperative fluid management in open gastrointestinal surgery: Goal-directed versus restrictive. Clinics 2012; 67(10): 1149-1155.
• 23. Bundgaard‐Nielsen M, Secher NH, Kehlet H. ‘Liberal’vs.‘restrictive’perioperative fluid therapy–a critical assessment of the evidence. Acta Anaesthesiologica Scandinavica 2009;53(7):843-851.
• 24. de Aguilar-Nascimento JE, Diniz BN, do Carmo AV, Silveira EAO, Silva RM. Clinical benefits after the implementation of a protocol of restricted perioperative intravenous crystalloid fluids in major abdominal operations. World Journal of Surgery 2009;33(5):925-930.
• 25. Warrillow SJ, Weinberg L, Parker F, Calzavacca P, Licari E. Perioperative fluid prescription, complications, and outcomes in major elective open gastrointestinal surgery. Anaesth Intensive Care 2010;38:251-265.
• 26. Futier E, Constantin JM, Petit A, Chanques G, Kwiatkowski F, Flamein R, et. al. Conservative vs restrictive individualized goal-directed fluid replacement strategy in major abdominal surgery: A prospective randomized trial. Archives of Surgery Journal 2010;145(12):1193-1200.
• 27. Chau EH, Slinger P. Perioperative fluid management for pulmonary resection surgery and esophagectomy. Seminars in Cardiothoracic and Vascular Anesthesia 2014;18(1): 36-44.
• 28. Assaad S, Popescu W, Perrino A. Fluid management in thoracic surgery. Current Opinion in Anesthesiology 2013;26(1):31-39.
• 29. Searl CP, Perrino A. Fluid management in thoracic surgery. Anesthesiology Clinics 2012;30(4):641-655.
• 30. Cecconi M, Corredor C, Arulkumaran N, Abuella G, Ball J, Grounds RM, et. al. Clinical review: Goal-directed therapy-what is the evidence in surgical patients? The effect on different risk groups. Critical Care 2013;17(2):1.
• 31. Shoemaker WC, Montgomery ES, Kaplan E, Elwyn DH. Physiologic patterns in surviving and nonsurviving shock patients. Use of sequential cardiorespiratory variables in defining criteria for therapeutic goals and early warning of death. Archives of Surgery 1973;106: 630-636.
• 32. Holte K, Foss NB, Andersen J, Valentiner L, Lund C, Bie P, et. al. Liberal or restrictive fluid administration in fast-track colonic surgery: a randomized, double- blind study. British Journal Anaesthesiology 2007;99(4):500-508.
• 33. Holte K, Kristensen BB, Valentiner L, Kehlet H. Liberal Versus Restrictive Fluid Management in Knee Arthroplasty: A Randomized, Double-Blind Study. Anesthesia and Analgesia 2007;105(2):465-474.
• 34. MacKay G, Fearon K, McConnachie A, Serpell MG, Molloy RG, O’Dwyer PJ. Randomized clinical trial of the effect of postoperative intravenous fluid restriction on recovery after elective colorectal surgery. British Journal of Surgery 2006;93:
• 1469-1474.
• 35. Patel S, Lutz JM, Panchagnula U, Bansal S. Anesthesia and perioperative management of colorectal surgical patients – specific issues (part 2). Journal of Anaesthesiology Clinical Pharmacology 2012;28(3):304-313.
• 36. Vermeulen H, Hofland J, Legemate DA, Ubbink DT. Intravenous fluid restriction after major abdominal surgery: a randomized blinded clinical trial. Trials 2009;10(1):1.
• 37. E. Bennett-Guerrero. Hemodynamic Goal-Directed Therapy in High-Risk Surgical Patients. Journal of the American Medical Association 2014;311(21):2177-2178.
• 38. Roche AM, Miller TE, Gan TJ. Goal-directed fluid management with trans-oesophageal Doppler. Best Practise Research Clinical Anaesthesiology 2009;23: 327-334.
• 39. Wilms H, Mittal A, Haydock MD, Van Den Heever M, Devaud M, Windsor JA. A systematic review of goal directed fluid therapy: rating of evidence for goals and monitoring methods. Journal of Critical Care 2014;29(2):204-209.
• 40. Le Manach Y, Christoph KH, Lehot JJ, Vallet B, Goarin JP, Tavernier B, et. al. Can changes in arterial pressure be used to detect changes in cardiac output during volume expansion in the perioperative period? Anesthesiology 2013;117:1165-1174.
• 41. Bundgaard-Nielsen M, Ruhnau B, Secher NH, Secher NH, Kehlet H. Flow-related techniques for preoperative goal-directed fluid optimization. British Journal Anaesthesiology 2007;98:38–44.
• 42. Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated mata-analysis and a plea for some common sense. Critical Care Medicine 2013;41(7):1774-1781.
• 43. Trinooson CD, Gold ME. Impact of goal-directed perioperative fluid management in high-risk surgical procedures: a literature review. American Association of Nurse Anesthetists Journal 2013;81(5):357-368.
• 44. Funk DJ, Moretti EW, Gan TJ. Minimally invasive cardiac output monitoring in the perioperative setting. Anesthesia & Analgesia 2009;108: 887-897.
• 45. Romagnoli S, Romano SM, Bevilacqua S, Lazzeri C, Ciappi F, Dini D, et. al. Hemodynamic goal-directed therapy. A review. HSR Proceedings ın Intensive Care & Cardiovascular Anesthesia. 2009;1(1): 54-58.
• 46. Hamilton MA, Cecconi M, Rhodes A. A systematic review and meta-analysis on the use of preemptive hemodynamic intervention to improve postoperative outcomes in moderate and high-risk surgical patients. Anesthesia & Analgesia 2011;112: 1392-1402.
• 47. Benes J, Chytra I, Altmann P, Hluchy M, Kasal E, Svitak R, et. al. Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study. Critical Care 2010; 14(3):R118. doi:10.1186/cc9070.
• 48. Mayer J, Boldt J, Mengistu AM, Röhm KD, Suttner S. Goal-directed intraoperative therapy based on autocalibrated arterial pressure waveform analysis reduces hospital stay in high-risk surgical patients: a randomized, controlled trial. Critical Care 2010;14(1):R18. doi:10.1186/cc8875.
• 49. Giglio MT, Maruccin M, Testini M, Brienza N. Goal-directed haemodynamic therapy and gastrointestinal complications in major surgery: A meta-analysis of randomized controlled trials. British Journal of Anaesthesia 2009;103(5): 637-646.
• 50. Kassim DY, Esmat IM. Goal directed fluid therapy reduces major complications in elective surgery for abdominal aortic aneurysm: Liberal versus restrictive strategies. Egyptian Journal of Anaesthesia 2016;32(2):167-173.
• 51. Senagore AJ, Emery T, Luchtefeld M, Kim D, Dujovny N, Hoedema R. Fluid Management for Laparoscopic Colectomy: A Prospective, Randomized Assessment of Goal-Directed Administration of Balanced Salt Solution or Hetastarch Coupled with an Enhanced Recovery Program. Diseases of The Colon & Rectum 2009;52:12
• 52. Lopes MR, Oliveira MA, Pereira VOS, Lemos IPB, Auler JOC, Michard F. Goaldirected fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial. Critical Care 2007;11(5):R100. doi:10.1186/cc6117.
• 53. Phan TD, An VD'souza B, Rattray MJ, Johnston MJ, Cowie BS. A randomised controlled trial of fluid restriction compared to oesophageal Doppler-guided goal-directed fluid therapy in elective major colorectal surgery within an Enhanced Recovery After Surgery program. Anaesthesia and Intensive Care 2014;42(6):752.