oa Southern African Journal of Anaesthesia and Analgesia - Adult perioperative fluid management : "Between Scylla and Charybdis" : SASA 2009 Congress prize entries
Current practices in perioperative fluid management have their origins in the late 1950s and 1960s, when theories regarding salt and water distribution led ultimately to liberal perioperative fluid regimens. Classical teaching assumes replacement of a large preoperative deficit, high maintenance fluid requirements and aggressive replacement of presumed third space losses. Central to this teaching is the avoidance of hypovolaemia. While this remains a crucial objective, recent work suggests that hypervolaemia in the perioperative setting results in a number of deleterious consequences, many of which are seen only in the postoperative period and thus not immediately apparent to the anaesthetist. We are left with the dilemma of trying to avoid hypovolaemia and at the same time, limit fluid excess.
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