期刊
PERIOPERATIVE MEDICINE
卷 5, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s13741-016-0049-9
关键词
Enhanced recovery pathway; Enhanced recovery; Fluids; Colorectal surgery; Crystalloids; Colloids; Goal-directed fluid therapy; Carbohydrate drink; Hemodynamics
资金
- Baxter
- Cheetah Medical
- Edwards Life Sciences
- Mallinckrodt
- Pacira
Background: Enhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There is some controversy about the adoption of specific elements in enhanced recovery bundles because the relative importance of different components of ERPs is hard to discern (a consequence of multiple simultaneous changes in clinical practice when ERPs are initiated). There is evidence that specific approaches to fluid management are better than alternatives in patients undergoing colorectal surgery; however, several specific questions remain. Methods: In the Perioperative Quality Initiative (POQI) Fluids workgroup, we developed a framework broadly applicable to the perioperative management of intravenous fluid therapy in patients undergoing elective colorectal surgery within an ERP. Discussion: We discussed aspects of ERPs that impact fluid management and made recommendations or suggestions on topics such as bowel preparation; preoperative oral hydration; intraoperative fluid therapy with and without devices for goal-directed fluid therapy; and type of fluid.
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