Perioperative Fluid Management and Clinical Outcomes in Adults

Abstract

The administration of IV fluid to avoid dehydration, maintain an effective circulating volume, and prevent inadequate tissue perfusion should be considered, along with the maintenance of sleep, pain relief, and muscularrelaxation,acoreelementoftheperioperative practice of anesthesia. Knowledge of the effects of dif- ferent fluids has increased in recent years, and the choice of fluid type in a variety of clinical situations can now be rationally guided by an understanding of the physicochemical and biological properties of the vari- ous crystalloid and colloid solutions available. How- ever,therearefewusefulclinicaloutcomedatatoguide this decision. Deciding how much fluid to give has his- torically been more controversial than choosing which fluid to use. A number of clinical studies support the notion that an approach based on administering fluids to achieve maximal left ventricular stroke volume (while avoiding excess fluid administration and conse- quentimpairmentofleftventricularperformance)may improve outcomes. In this article, we review the avail- able fluid types and strategies of fluid administration and discuss their relationship to clinical outcomes in adults. (Anesth Analg 2005;100:1093-106)