Which intravenous fluid for the surgical patient COCC 2015

6 Pages • 5,009 Words • PDF • 213.7 KB
Uploaded at 2021-09-24 18:17

This document was submitted by our user and they confirm that they have the consent to share it. Assuming that you are writer or own the copyright of this document, report to us by using this DMCA report button.


REVIEW URRENT C OPINION

Which intravenous fluid for the surgical patient? Sweyn S. Garrioch and Michael A. Gillies

Purpose of review This review appraises recent evidence and provides clinical guidance on optimal perioperative fluid therapy. Recent findings Choice of perioperative intravenous fluid continues to be the source of much debate. Not all crystalloids are equivalent, and there is growing evidence that balanced solutions are superior to 0.9% saline in many situations. Recent evidence from the critical care population has highlighted risks associated with synthetic colloids; this and the absence of demonstrable benefit in the surgical population make it difficult to recommend their use in the perioperative period. Giving the correct amount of fluid may be as important as the choice of the fluid used. There is increasing evidence that excessive positive fluid balance is harmful to patients but there have been no randomized trials comparing maintenance fluid strategy. A knowledge of the physiology and accurate estimation of fluid balance is important for water and electrolyte homeostasis until the patient is able to resume adequate enteral nutrition. Summary Balanced crystalloids are the fluid of choice for perioperative resuscitation and optimization in patients not requiring blood products. Avoidance of a grossly positive sodium and water balance during the maintenance phase is likely to be important, but has not been assessed in randomized trials. Keywords balanced crystalloids, colloids, intravenous fluid, perioperative medicine

INTRODUCTION Fluid therapy is a central, if highly controversial, aspect of perioperative management, essential for fluid and electrolyte homeostasis, adequate cardiac output and tissue perfusion. Inappropriate fluid therapy is associated with increased complications, tissue oedema, delayed wound healing, fluid overload, kidney and other organ dysfunction, coagulation abnormality and excessive transfusion [1–13]. Despite over 175 years of experience with intravenous fluids [14], many of the traditional beliefs held around this therapy are not based on robust scientific evidence, and many controversies remain: type and composition of fluid; indication for fluid therapy; resuscitation goals and endpoints. A recent report into perioperative care suggested that 20% of hospitalized adults receive inappropriate fluid therapy [15]. Approximately 230 million patients undergo surgery worldwide each year [16] and overall rates of mortality are low, quoted at between 1 and 4%. Epidemiological evidence, however, suggests that this large number of surgical patients conceals a smaller high-risk subgroup, accounting for a www.co-criticalcare.com

high proportion of perioperative morbidity and mortality. In many patients having minor to moderate elective surgery, choice of fluid may have a limited bearing on outcome. There are few large prospective trials examining the effect of particular types of fluid or modes of fluid administration in the wider surgical population. Moreover, low overall rates of death and complication in patients undergoing routine surgery mean that any such trial would need to be very large indeed. Hence, much of the available data are extrapolated from studies in other smaller patient groups (e.g. critically ill adults, patients undergoing high-risk surgery) or studies examining physiological endpoints. The high-risk subgroup typically includes older, sicker patients undergoing major or non-elective surgery [17]. In these patients, certain aspects of perioperative care, including fluid therapy, may have a more important Department of Anesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK Correspondence to Dr Michael Gillies, E-mail: [email protected] Curr Opin Crit Care 2015, 21:358–363 DOI:10.1097/MCC.0000000000000222 Volume 21  Number 4  August 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Perioperative fluid therapy Garrioch and Gillies

KEY POINTS  Balanced crystalloid solutions are superior to 0.9% saline in the majority of situations.  Lack of demonstrable outcome benefit for synthetic colloids in surgical patients and harm in the critical care population suggest synthetic colloids should not be used in the perioperative period.  Avoidance of salt and water overload is an important goal in the perioperative period.  Due to a lack of trial evidence, accurate charting and good physiological knowledge are vital to good maintenance fluid practice.  Further trials are required to determine optimal perioperative fluid strategies.

bearing on the development of complications and ultimate outcome. The scope of this article is to appraise recent evidence and provide clinical guidance with specific regard to perioperative fluid therapy.

PHYSIOLOGICAL CONSIDERATIONS Intravenous fluids fall into two broad categories: crystalloid and colloid. Crystalloids are aqueous solutions of electrolytes, small organic anions or sugars, and are available in varying compositions (Table 1). These small-solute molecules are able to diffuse freely between fluid compartments. Crystalloids represent the original and the oldest form of intravenous fluid therapy [14]. Colloids are suspensions of larger, insoluble molecules, and offer the theoretical advantage of longer plasma half-life and sustained volume

expansion. This has been attributed to more restricted diffusion properties and increased plasma oncotic pressure. Colloids are traditionally classified as naturally occurring (e.g. albumin) and synthetic (e.g. HES, dextrans and gelatins). Studies in healthy human volunteers suggest that much of a colloid solution remains in the intravascular space at 1 h, compared to only 20% of crystalloid solution [18]. In recent years, the traditional theories of fluid mechanics, proposed by Starling, have been revised, and a new model involving the glycocalyx layer (GCL) has been proposed [19,20]. The GCL is a dense layer of glycosaminoglycans, which lines and is connected to the vascular endothelium. The GCL, vascular endothelium and basement membrane form a barrier between the intravascular and interstitial spaces. The GCL is semi-permeable to anionic macromolecules (such as albumin), impermeable to red bloods cells, and maintains a relatively proteinfree space below. This results in a low colloid oncotic pressure in the intracellular clefts. It is this oncotic pressure which more accurately determines the microcirculatory fluid filtration and thus the fluid distribution in healthy and disease conditions. Colloids are thought to adsorb to the GCL, restricting ultra-filtration and increasing plasma oncotic pressure. In healthy condition, they increase plasma volume expansion compared with crystalloids, which diffuse freely into the interstitial space (ISF). The GCL, however, can be damaged by rapid infusion of fluids, hyperglycaemia, ischaemia, surgery, sepsis and inflammation. This could account for the observed interstitial expansion associated with colloid infusion in surgical and critically ill patients. It may also explain the findings of studies such as FEAST where bolus fluid therapy was compared with maintenance infusion for resuscitation of seriously unwell children in Africa. Despite

Table 1. Contents of commonly available crystalloid solutions

Content Sodium (mmol/l) Chloride (mmol/l) Potassium (mmol/l) Bicarbonate Calcium (mmol/l)

Plasma

0.9% Sodium chloride

0.18% Sodium chloride with 4% glucose

0.45% Sodium chloride with 4% glucose

5% Glucose

Hartmann’s

Plasma-Lyte 148

135–145

154

31

77

0

131

140

95–105

154

31

77

0

111

98

3.5–5.3

0

0

0

0

5

5

24–32

0

0

0

0

29 (lactate)

50 (27 acetate; 23 gluconate)

2.2–2.6

0

0

0

0

2

0 1.5

Magnesium (mmol/l)

0.8–1.2

0

0

0

0

0

Glucose (mmol/l)

3.5–5.5

0

222 (40 g)

222 (40 g)

278 (40 g)

0

0

7.35–7.45

4.5–7.0

4.5

4.5

3.5–5.5

5.0–7.0

4.0–6.5

275–295

308

284

376

278

278

295

pH Osmolarity (mOsm/l)

1070-5295 Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved.

www.co-criticalcare.com

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

359

Postoperative problems

more rapid restoration of haemodynamic variables in the bolus therapy group, mortality was increased [21].

Crystalloid solutions The most commonly used crystalloid in clinical practice is 0.9% saline [22], and it contains 154 mmol/l of sodium and chloride ions. This is a higher concentration of chloride than that found in plasma (approximately 100 mmol/l). Infusions of large volumes of chloride-rich solutions, such as 0.9% saline, can result in metabolic acidosis by altering the strong ion difference [23]. This phenomenon has been demonstrated both in healthy volunteers [24] and surgical patients [25,26]. Hyperchloraemia may also be associated with decreased renal blood flow and glomerular filtration rate [24,27,28]. ‘Balanced crystalloid solutions’ may offer a better alternative to 0.9% saline. Balanced solutions resemble plasma more closely and have lower chloride ion concentrations than saline, chloride ions being typically replaced with bicarbonate or organic anions (e.g. acetate or lactate). Use of these solutions may mitigate the undesirable effects of normal saline on acid–base balance and renal blood flow. Commonly used balanced solutions in clinical practice include lactated Ringer’s solution, PlasmaLyte 148 or Stereofundin. A recent large observational study of over 30 000 adult patients undergoing major abdominal surgery compared morbidity and mortality between those receiving 0.9% saline to 926 patients who only received Plasma-Lyte 148 on the day of surgery [29]. This showed a reduction in postoperative infection, renal failure requiring dialysis, blood transfusion, electrolyte disturbance and acidosis in the patients receiving the balanced crystalloid solution. It also reported a reduction in unadjusted in-hospital mortality [5.6% in the 0.9% saline group to 2.9% in the Plasma-Lyte 148 group (P < 0.001)]. Another large cohort study of over 9000 patients showed an increased 30-day mortality [odds ratio (OR) 2.05, 95% confidence interval (CI) 1.62–2.59] in noncardiac surgical patients who were hyperchloraemic [30]. Some clinicians have traditionally avoided balanced solutions in certain situations due to concerns regarding hyperkalaemia, for example, renal failure, during renal transplantation surgery and treatment of diabetic ketoacidosis (DKA). However, there is evidence to support the use of balanced crystalloids in these situations. A randomized controlled trial comparing 0.9% saline compared to Ringer’s lactate solution in 51 patients undergoing renal transplant surgery demonstrated higher rate of clinically 360

www.co-criticalcare.com

significant hyperkalaemia (29 vs. 0%; P ¼ 0.05) and metabolic acidosis (31 vs. 0%; P ¼ 0.04) in patients receiving 0.9% saline, although there was no significant difference in renal function [31]. In liver transplantation, a high chloride-based fluid regime has been associated with acute kidney injury [32]. There is also evidence to support the use of balance solutions in DKA [33,34]. A prospective, non-randomized study of 760 intensive care patients, comparing use of chloriderich solutions compared with balanced crystalloids, demonstrated reduced acidosis with no change in sodium or potassium concentrations [35]. In a separate analysis of these patients, the low chloride group was found to have a significantly lower incidence of RIFLE-defined acute kidney injury (8.4 vs. 14%; P < 0.001) and a lower need for renal replacement therapy (6.3 vs. 10%; P ¼ 0.004) [36]. A large cohort study in ICU patients with sepsis has also shown an association with balanced crystalloid use and reduced hospital mortality [relative risk (RR) 0.86, 95% CI 0.78–0.94] [37]. These findings suggest that balanced crystalloids are the fluids of choice for fluid resuscitation in the perioperative setting, and the use of 0.9% saline should be reserved for specific conditions such as replacement of gastric fluid losses.

Colloids Colloids are suspensions of large molecules, typically in 0.9% saline, but more recently in balanced solutions. As described above, colloids have longer plasma half-lives than their crystalloid counterparts, increased plasma oncotic pressure and reduced ultra-filtration. Hence they have been attractive resuscitation fluids. However, in critical illness, endothelial permeability is increased and these larger molecules may diffuse into the interstitial space, possibly resulting in reduced efficacy, increased tissue oedema and end-organ damage. Albumin 4 or 5% is considered to be the reference colloid solution. It is manufactured from blood donation and is relatively expensive to produce. It enjoyed widespread use as a resuscitation fluid until 1998 when a Cochrane review concluded that its use was associated with an increased risk of death (RR 1.68, 95% CI 1.26–2.23, P < 0.01) [38]. This review was heavily criticized for including an extremely diverse group of small trials including burns, trauma, septic, surgical and neonatal patients. However, it led to a rise in use of synthetic colloids, for example, the starch and gelatine-based solutions described below. The Saline versus Albumin Fluid Evaluation (SAFE) study examined 6997 adults in ICU in Australia and New Zealand [39]. The study Volume 21  Number 4  August 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Perioperative fluid therapy Garrioch and Gillies

compared resuscitation with 4% albumin to 0.9% saline, and found no difference in 28-day mortality or incidence of new organ failure between the two fluids. Two predefined subgroups showed how the same fluid might cause a different outcome in two different situations. A harmful effect in patients with traumatic brain injury in the albumin group was observed (RR 1.63, 95% CI 1.17–2.26, P ¼ 0.003), whilst there was a reduced risk of mortality in patients with severe sepsis (RR 0.87, 95% CI 0.74–1.02, P ¼ 0.09), which did not reach statistical significance. Further randomized control trials have since been completed, which have not confirmed albumin’s beneficial effect in sepsis [40]. There is little evidence to support the widespread use of albumin in the perioperative period at present. Over the past two decades, hydroxyethyl starches (HES) and gelatins have been the most widely used synthetic colloids. However, concerns have existed about the potentially harmful effects associated with their use for several years. HES solutions have been shown to impair haemostasis and increased postoperative blood loss [1]. Gelatin solutions are used less widely and so have been less well investigated; however, observational data have shown them to be nephrotoxic to a similar extent as HES [41]. Gelatins also have a significant rate of anaphylaxis [42,43].

PERIOPERATIVE FLUID MANAGEMENT A recent special article by the Acute Dialysis Quality Initiative (ADQI) proposed four phases of fluid therapy: resuscitation, optimization, maintenance and de-escalation. This classification lends itself to perioperative period, and we will consider the optimum approach to fluid management under these headings.

Resuscitation Surgical patients may need resuscitation for hypovolaemia due to dehydration, haemorrhage or sepsis. The management of major haemorrhage and blood component therapy is not considered in this review; however, colloidal solutions have been recommended for the treatment of hypovolaemia. The postulated advantages of rapid resuscitation, a sustained increase in cardiac output and end-organ perfusion associated with colloids offer an attractive theory of physiological benefit; however, clinical evidence has not substantiated this. The SAFE study described above not only demonstrated no overall clinical benefit associated with the choice of fluid but also that compared to animal and human volunteer studies where crystalloid-to-colloid ratios of up to 4 : 1 had been required to reach the same endpoints,

the ratio of administered saline to albumin was only 1 : 1.4. This finding has been replicated in other large clinical trials using synthetic colloids; both the CRISTAL and the VISEP studies found a similar ratio of 1 : 1.5 [2,44]. HES, in particular, is associated with nephrotoxicity [2–4] and higher mortality when used for resuscitation in the critically ill [3,45]. The applicability of these studies to the wider surgical population is not known; however, high-risk surgical patients requiring resuscitation with colloidal solution may become those who ultimately require critical care. The CRISTAL study – an open-label, randomized trial of 2857 patients – was published in 2013 and assessed the outcome of crystalloid vs. colloid for resuscitation of hypovolaemic ICU patients, the majority of whom had severe sepsis. This study found no difference in 30-day mortality, but a reduction in 90-day mortality associated with the use of colloid (RR 0.92, 95% CI 0.86–0.99, P ¼ 0.03). However, the validity of this trial has been questioned; several different colloid and crystalloid solutions were used and it was conducted over a 9year period during which fluid practices evolved [44]. Current guidance recommends that semi-synthetic colloids are avoided in the intensive care population; due to these safety concerns and lack of demonstrable superiority, they cannot be recommended in the perioperative setting [46].

Optimization In 1973, Shoemaker [47,48] observed that patients suffering from surgical shock were more likely to survive if they were able to achieve higher levels of cardiac output (CO) and tissue oxygen delivery (DO2). Since then, many trials of goal-directed haemodynamic therapy have been conducted, typically involving administration of colloidal solutions to a predetermined endpoint, with or without the addition of low-dose inotropes. A recent authoritative systematic review conducted on the subject included 31 trials [49]. The OPTIMISE trial compared a haemodynamic therapy algorithm with usual care in 734 high-risk patients undergoing gastrointestinal surgery [50]. Although this study reported a trend towards a reduced incidence of a primary outcome of death or complication within 30 days, it did not reach statistical significance. An updated systematic review and meta-analysis suggested haemodynamic therapy was associated with reduced complication rate and length of hospital stay. Few studies examine the type of fluid used in haemodynamic therapy. A study by Yates et al. [51] compared balanced crystalloid with 6% HES for haemodynamic therapy in 206 patients undergoing major gastrointestinal surgery and found no difference in outcome and similar volumes of fluid administered to each group.

1070-5295 Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved.

www.co-criticalcare.com

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

361

Postoperative problems Table 2. Electrolyte content of various bodily fluids and average volumes in an adult Bodily fluid Gastric

Sodium (mmol/l)

Potassium (mmol/l)

Chloride (mmol/l)

Volume/day (l)

50

15

140

2–3

Bile

145

5

100

0.5–1

Small bowel

140

11

70–130

Varies

Ileostomy

50

4

25

0.5

Colostomy

60

15

40

0.1–0.2

Diarrhoea

30–140

30–70

Maintenance and de-escalation There have been no randomized trials comparing different maintenance intravenous fluids, so practice in this area is based on clinical experience and consensus opinion. The National Institute for Health and Care Excellence (NICE) issued the following advice [52]: the maintenance requirements of water in adults is 25–30 ml/kg/day; ideal body weight is used in obese patients; 1 mmol/kg/day of potassium, sodium and chloride is required; 50–100 g/day of glucose to limit starvation ketosis is also recommended (this will not meet the patients’ nutritional needs). The composition of commonly available fluids is outlined in Table 1. When calculating fluid requirement, additional losses need to be taken into consideration, for example, pre-existing deficits and extra losses from drains or gastrointestinal tract. These additional losses should be replaced with a fluid with similar electrolyte composition, for example, 0.9% saline for gastric fluid losses to prevent hypochloraemic alkalosis. A summary of the electrolyte contents of clinically important body fluids is provided in Table 2. The electrolyte content of intravenous medication (e.g. antibiotics) should also be considered; these may also have high sodium content. It is recommended that in addition to standard observations, fluid balance and body weights should be recorded, and full blood counts, electrolytes and renal function should be measured. Liberal administration of fluids in the perioperative period may result in a postoperative bodyweight increase of 3–6 kg. This may be due to fluid given to fill the imaginary ‘third space’ [53–55], over-estimation of insensible losses, replacement of a deficit which does not exist after fasting [56] and targeting values of central venous pressure which may be harmful. Evaporation from open abdominal surgery is only in the region of 0.5–1 ml/kg/h [54], and this has been over-estimated for many years. There is evidence that we should strive to avoid a grossly positive fluid balance as this is associated with poor patient outcome [57–61]. Excessive maintenance fluid can 362

www.co-criticalcare.com

Varies

contribute to this. De-escalation from intravenous fluid to enteral nutrition should be made as soon as possible.

CONCLUSION Intravenous fluid therapy is an important aspect of perioperative care. Evidence suggests that we may be able to modify outcome by our choice of intravenous resuscitation fluid particularly in high-risk patients. Current clinical evidence favours the use of balanced crystalloids for perioperative fluid therapy and resuscitation. There is no evidence to suggest that synthetic colloids are superior to crystalloids, and because of the possibility of harm, they cannot be recommended in this setting. There are no randomized trials comparing maintenance fluid strategies, but avoidance of salt and water overload appears to be important, as well as knowledge of the electrolyte composition of any additional fluid losses. Further research is required to address optimal fluid balance aims and resuscitation endpoints in the perioperative setting. Acknowledgements None. Financial support and sponsorship Michael Gillies holds a Chief Scientist’s Office Scotland NHS Research Scheme Fellowship. Conflicts of interest There are no conflicts of interest.

REFERENCES AND RECOMMENDED READING Papers of particular interest, published within the annual period of review, have been highlighted as: & of special interest && of outstanding interest 1. De Jonge E, Levi M. Effects of different plasma substitutes on blood coagulation: a comparative review. Crit Care Med 2001; 29:1261–1267. 2. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008; 358:125–139. 3. Perner A, Haase N, Guttormsen AB, et al. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. N Engl J Med 2012; 367:124–134.

Volume 21  Number 4  August 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Perioperative fluid therapy Garrioch and Gillies 4. Myburgh JA, Finfer S, Bellomo R, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med 2012; 367:1901–1911. 5. LeTourneau JL, Pinney J, Phillips CR. Extravascular lung water predicts progression to acute lung injury in patients with increased risk. Crit Care Med 2012; 40:847–854. 6. Marik PE. Iatrogenic salt water drowning and the hazards of a high central venous pressure. Ann Intensive Care 2014; 4:21. 7. Cordemans C, De Laet I, Van Regenmortel N, et al. Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance. Ann Intensive Care 2012; 2 (Suppl 1): S1. 8. Daugherty EL, Hongyan Liang, Taichman D, et al. Abdominal compartment syndrome is common in medical intensive care unit patients receiving largevolume resuscitation. J Intensive Care Med 2007; 22:294–299. 9. Payen D, de Pont AC, Sakr Y, et al. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 2008; 12:R74. 10. Prowle JR, Echeverri JE, Ligabo EV, et al. Fluid balance and acute kidney injury. Nat Rev Nephrol 2010; 6:107–115. 11. Legrand M, Dupuis C, Simon C, et al. Association between systemic hemodynamics and septic acute kidney injury in critically ill patients: a retrospective observational study. Crit Care 2013; 17:R278. 12. Jozwiak M, Silva S, Persichini R, et al. Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome. Crit Care Med 2013; 41:472–480. 13. Wang C-H, Hsieh W-H, Chou H-C, et al. Liberal versus restricted fluid resuscitation strategies in trauma patients: a systematic review and metaanalysis of randomized controlled trials and observational studies. Crit Care Med 2014; 42:954–961. 14. Latta T. Saline venous injection in cases of malignant cholera, performed while in the vapour-bath. Lancet 1832; 19:173–176. 15. Cook P, Bellis M. Knowing the risk. Public Health 2001; 115:54–61. 16. Weiser TG, Regenbogen SE, Thompson KD, et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 2008; 372:139–144. 17. Pearse RM, Harrison Da, James P, et al. Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit Care 2006; 10:R81. 18. Lobo DN, Stanga Z, Aloysius MM, et al. Effect of volume loading with 1 l intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three-way crossover study in healthy volunteers. Crit Care Med 2010; 38:. 19. Levick JR, Michel CC. Microvascular fluid exchange and the revised Starling principle. Cardiovasc Res 2010; 87:198–210. 20. Woodcock TE, Woodcock TM. Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. Br J Anaesth 2012; 108:384–394. 21. Maitland K, Kiguli S, Opoka RO, et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med 2011; 364:2483–2495. 22. Stoneham M, Hill E. Variability in postoperative fluid and electrolyte prescription. Br J Clin Pract 1997. 23. Chawla G, Drummond G. Water, strong ions, and weak ions. Contin Educ Anaesth Crit Care Pain 2008; 8:108–112. 24. Williams EL, Hildebrand KL, McCormick SA, Bedel MJ. The effect of intravenous lactated Ringer’s solution versus 0.9% sodium chloride solution on serum osmolality in human volunteers. Anesth Analg 1999; 88:999–1003. 25. McFarlane C, Lee A. A comparison of Plasmalyte 148 and 0.9% saline for intra-operative fluid replacement. Anaesthesia 1994. 26. Scheingraber S, Rehm M. Rapid saline infusion produces hyperchloremic acidosis in patients undergoing gynecologic surgery. Anesthesiology 1999. 27. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte1 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg 2012; 256:18–24. 28. Reid F, Lobo DN, Williams RN, et al. Hartmann’s solution: a randomized double-blind crossover study. Clin Sci (Lond) 2003; 104:17–24. 29. Shaw AD, Bagshaw SM, Goldstein SL, et al. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte. Ann Surg 2012; 255:821–829. 30. McCluskey SA, Karkouti K, Wijeysundera D, et al. Hyperchloremia after noncardiac surgery is independently associated with increased morbidity and mortality: a propensity-matched cohort study. Anesth Analg 2013; 117:412–421. 31. O’Malley CMN, Frumento RJ, Hardy MA, et al. A randomized, double-blind comparison of lactated Ringer’s solution and 0.9% NaCl during renal transplantation. Anesth Analg 2005; 100:1518–1524. 32. Nadeem A, Salahuddin N, ElHazmi A, et al. Chloride-liberal fluids are associated with acute kidney injury after liver transplantation. Crit Care 2014; 18:625.

33. Mahler SA, Conrad SA, Wang H, Arnold TC. Resuscitation with balanced electrolyte solution prevents hyperchloremic metabolic acidosis in patients with diabetic ketoacidosis. Am J Emerg Med 2011; 29:670–674. 34. Chua H-R, Venkatesh B, Stachowski E, et al. Plasma-Lyte 148 vs. 0.9% saline for fluid resuscitation in diabetic ketoacidosis. J Crit Care 2012; 27:138– 145. 35. Yunos NM, Kim IB, Bellomo R, et al. The biochemical effects of restricting chloride-rich fluids in intensive care. Crit Care Med 2011; 39:2419–2424. 36. Yunos NM, Bellomo R, Hegarty C, et al. Association between a chloride-liberal vs. chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. J Am Med Assoc 2012; 308:1566–1572. 37. Raghunathan K, Shaw A, Nathanson B, et al. Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis. Crit Care Med 2014; 42:1585–1591. 38. Cochrane Injuries Group. Human albumin administration in critically ill patients: systematic review of randomised controlled trials. BMJ 1998; 317:235–240. 39. Finfer S, Bellomo R, Boyce N, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 2004; 350:2247– 2256. 40. Caironi P, Tognoni G, Masson S, et al. Albumin replacement in patients with severe sepsis or septic shock. N Engl J Med 2014; 370:1412–1421. 41. Bayer O, Reinhart K, Sakr Y, et al. Renal effects of synthetic colloids and crystalloids in patients with severe sepsis: A prospective sequential comparison. Crit Care Med 2011; 39:1335–1342. 42. Laxenaire MC, Charpentier C, Feldman L. Re´actions anaphylactoı¨des aux substituts colloı¨daux du plasma: incidence, facteurs de risque, me´canismes. Ann Fr Anesth Reanim 1994; 13:301–310. 43. Marrel J, Christ D, Spahn DR. Anaphylactic shock after sensitization to gelatin. Br J Anaesth 2011; 107:647–648. 44. Annane D, Siami S, Jaber S, et al. Effects of fluid resuscitation with colloids vs. crystalloids on mortality in critically ill patients presenting with hypovolemic shock: the CRISTAL randomized trial. J Am Med Assoc 2013; 310:1809– 1817. 45. Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane database Syst Rev 2013; 2:CD000567. 46. Gillies MA, Habicher M, Jhanji S, et al. Incidence of postoperative death and acute kidney injury associated with i.v. 6% hydroxyethyl starch use: systematic review and meta-analysis. Br J Anaesth 2014; 112:25–34. 47. Shoemaker WC. Physiologic patterns in surviving and nonsurviving shock patients. Arch Surg 1973; 106:630. 48. Shoemaker WC. Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest J 1988; 94:1176. 49. Grocott MPW, Dushianthan A, Hamilton MA, et al. Perioperative increase in global blood flow to explicit defined goals and outcomes after surgery: a Cochrane Systematic Review. Br J Anaesth 2013; 111:535–548. 50. Pearse RM, Harrison DA, MacDonald N, et al. Effect of a perioperative, cardiac output-guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: a randomized clinical trial and systematic review. J Am Med Assoc 2014; 311:2181–2190. 51. Yates DRA, Davies SJ, Milner HE, Wilson RJT. Crystalloid or colloid for goaldirected fluid therapy in colorectal surgery. Br J Anaesth 2013. 52. Intravenous fluid therapy in adults in hospital j Guidance and guidelines j NICE. NICE; [cited 2015 Jan 5]. http://www.nice.org.uk/guidance/cg174. 53. Jacob M, Chappell D, Rehm M. The ‘third space’: fact or fiction? Best Pract Res Clin Anaesthesiol 2009; 23:145–157. 54. Lamke LO, Nilsson GE, Reithner HL. Water loss by evaporation from the abdominal cavity during surgery. Acta Chir Scand 1977; 143:279–284. 55. Brandstrup B, Svensen C, Engquist A. Hemorrhage and operation cause a contraction of the extracellular space needing replacement: evidence and implications? A systematic review. Surgery 2006; 139:419–432. 56. Jacob M, Chappell D, Conzen P, et al. Blood volume is normal after preoperative overnight fasting. Acta Anaesthesiol Scand 2008; 52:522–529. 57. Schmidt M, Bailey M, Kelly J, et al. Impact of fluid balance on outcome of adult patients treated with extracorporeal membrane oxygenation. Intensive Care Med 2014; 40:1256–1266. 58. Grams ME, Estrella MM, Coresh J, et al., for the National Heart and Blood Institute Acute Respiratory Distress Syndrome Network L. Fluid balance, diuretic use, and mortality in acute kidney injury. Clin J Am Soc Nephrol 2011; 6:966–973. 59. Bellomo R, Cass A, Cole L, et al. An observational study fluid balance and patient outcomes in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy trial. Crit Care Med 2012; 40:1753–1760. 60. Bouchard J, Soroko SB, Chertow GM, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int 2009; 76:422–427. 61. Nisanevich V, Felsenstein I, Almogy G, et al. Effect of intraoperative fluid management on outcome after intraabdominal surgery. Anesthesiology 2005; 103:25–32.

1070-5295 Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved.

www.co-criticalcare.com

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

363
Which intravenous fluid for the surgical patient COCC 2015

Related documents

6 Pages • 5,009 Words • PDF • 213.7 KB

17 Pages • 8,656 Words • PDF • 132.4 KB

1,561 Pages • 371,358 Words • PDF • 218.4 MB

11 Pages • 7,455 Words • PDF • 569.9 KB

7 Pages • 4,252 Words • PDF • 1.4 MB

5 Pages • 2,841 Words • PDF • 512.9 KB

9 Pages • 5,591 Words • PDF • 308 KB

185 Pages • PDF • 32 MB

3 Pages • 2,259 Words • PDF • 845.4 KB

840 Pages • 330,575 Words • PDF • 9.2 MB