Key result
A flow-guided approach to perioperative fluid administration was associated with a significant reduction in mortality compared with control protocols (OR 0.82).
Odds Ratio: 0.82 (95% CI 0.67–0.99)
p-value: p=0.04
A flow-guided approach using hemodynamic variables like stroke volume and cardiac output is recommended for optimizing perioperative fluid management.
Flow-guided fluid management may reduce postoperative complications; leaves open optimal colloid use and needs prospective trials before routine adoption.
Perioperative fluid management remains controversial. Nevertheless, its optimization is essential to reducing the risk of postoperative complications, which have been shown to profoundly affect patients' short- and long-term outcomes. Current evidence favors a "flow-guided" approach to perioperative fluid administration, which uses variables such as stroke volume and cardiac output as the basis for guiding fluid requirements. The optimal fluid is controversial, although colloids appear to have some physiologic advantages over crystalloids. Minimally invasive technologies have emerged for intraoperative monitoring of blood flow, which may enable more precise fluid titration.
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Mark A. Hamilton (2009) conducted a review in High-risk elective or emergency surgery (n=4,546). Flow-guided fluid therapy vs. Control protocols (traditional physiologic targets) was evaluated on Mortality (OR 0.82, 95% CI 0.67-0.99, p=0.04). A flow-guided approach to perioperative fluid administration was associated with a significant reduction in mortality compared with control protocols (OR 0.82).
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