State of the art in fluid and volume therapy: Auser-friendly staged concept. English version

Rehm, M.; Hulde, N.; Kammerer, T.; Meidert, A. S. und Hofmann-Kiefer, K. (2019): State of the art in fluid and volume therapy: Auser-friendly staged concept. English version. In: Anaesthesist, Bd. 68: S. 1-14

Abstract

Adequate intraoperative infusion therapy is essential for the perioperative outcome of apatient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using arational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space. Fluid loss via urine excretion or insensible perspiration (0.5-1.0ml/kg/h) should be replaced with balanced, isooncotic, crystalloid infusion solutions in aratio of 1:1. Volume therapy stage1: intraoperative volume losses up to ablood loss corresponding to 20% of the patient's total blood volume are compensated for by balanced crystalloids in aratio of 4-5:1. Stage2: blood losses exceeding this level are to be treated with isooncotic colloids (preferably balanced) in a1:1ratio. In this regard taking into consideration the contraindications, e.g., sepsis, burns, critical illness (usually patients in the intensive care unit), impaired renal function or renal replacement therapy, intracranial hemorrhage, or severe coagulopathy, artificial colloids such as hydroxyethyl starch (HES) can be used perioperatively for volume replacement. Stage3: if an allogeneic blood transfusion is indicated, blood and blood products are applied in a differentiated manner.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0003-2417
• Sprache: Englisch