Perioperative Fluid Management - 27/07/23

Doi : 10.1016/j.anclin.2023.03.001

Domagoj Mladinov, MD, PhD ^a, Erin Isaza, BS ^b, Andre F. Gosling, MD ^c, Adrienne L. Clark, MD ^d, Jasleen Kukreja, MD, MPH ^e, Marek Brzezinski, MD, PhD ^f,^⁎
^a Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 75 Francis Street, CWN-L1, Boston, MA 02115, USA
^b University of California, San Francisco, School of Medicine, 500 Parnassus Avenue, MU 405 W San Francisco, CA 94143, USA
^c Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, 619 19th Street South, JT 845D, Birmingham, AL 35249, USA
^d Department of Anesthesia and Perioperative Care, University of California, 500 Parnassus Avenue, MU 405 W San Francisco, CA 94143, USA
^e Division of Cardiothoracic Surgery, Department of Surgery, University of California, 500 Parnassus Avenue, MU 405 W San Francisco, CA 94143, USA
^f Department of Anesthesia and Perioperative Care, University of California, VA Medical Center-San Francisco, 4150 Clement Street, San Francisco CA 94121, USA

^∗Corresponding author. VA Medical Center, Anesthesiology Service (129), 4150 Clement Street, San Francisco, CA 94121.VA Medical CenterAnesthesiology Service (129)4150 Clement StreetSan FranciscoCA94121

Résumé

The medical complexity of the geriatric patients has been steadily rising. Still, as outcomes of surgical procedures in the elderly are improving, centers are pushing boundaries. There is also a growing appreciation of the importance of perioperative fluid management on postoperative outcomes, especially in the elderly. Optimal fluid management in this cohort is challenging due to the combination of age-related physiological changes in organ function, increased comorbid burden, and larger fluid shifts during more complex surgical procedures. The current state-of-the-art approach to fluid management in the perioperative period is outlined.

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Keywords : Fluid therapy, Resuscitation, Perioperative medicine, Anesthesia, Surgery, Geriatrics