Why the study?
Standardized definitions of restrictive or liberal fluid regimens are lacking due to conflicting evidence, institutional protocols, and personal preferences, alongside challenges in patient selection within standardized ERAS protocols.
Does restrictive perioperative fluid management improve postoperative outcomes in patients undergoing colorectal surgery?
Does restrictive perioperative fluid management improve postoperative outcomes in patients undergoing colorectal surgery?
Restrictive perioperative fluid management in elective colorectal surgery within ERAS pathways is safe and helps prevent complications associated with fluid overload, though goal-directed therapy remains necessary for high-risk patients.
May guide total fluid and weight gain thresholds in colorectal ERAS; leaves open perfusion rate validation in prospective trials.
The present review discusses restrictive perioperative fluid protocols within enhanced recovery after surgery (ERAS) pathways. Standardized definitions of a restrictive or liberal fluid regimen are lacking since they depend on conflicting evidence, institutional protocols, and personal preferences. Challenges related to restrictive fluid protocols are related to proper patient selection within standardized ERAS protocols. On the other hand, invasive goal-directed fluid therapy (GDFT) is reserved for more challenging disease presentations and polymorbid and frail patients. While the perfusion rate (mL/kg/h) appears less predictive for postoperative outcomes, the authors identified critical thresholds related to total intravenous fluids and weight gain. These thresholds are discussed within the available evidence. The authors aim to introduce their institutional approach to standardized practice.
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Deslarzes et al. (2024) studied this question.
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