DOI: 10.1097/00000539-200103001-00012
,
Issn Print: 0003-2999
Publication Date: 2001/03/01
Current Concepts in Perioperative Fluid Management
Donald S. Prough; Christer Svens´en
Excerpt
Although most aspects of perioperative fluid management have remained relatively constant for more than two decades, new concepts and practices are currently evolving. Until the mid-to-late 1960s, the prevailing strategy of perioperative fluid management was rigid restriction (1). After Shires and colleagues (2,3) convincingly demonstrated that major surgery and trauma were associated with substantial intravascular fluid deficits, perioperative volume replacement became much less restrictive. In the 1970s, attention focused on the still-unresolved crystalloid/colloid controversy. Currently, investigators are applying kinetic analysis, using principles similar to those of pharmacokinetics, to better define responses to perioperative fluid administration (4). Development of new colloid solutions, in terms of the characteristics of both the colloids and their diluents, promises to reduce problems associated with existing formulations. Research into the components of conventional crystalloid solutions may even prompt revisions in the composition of these common anesthetic tools.
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