Beschreibung:
<p>LEARNING POINTS Perioperative fluid therapy is associated with potential benefits and harm, yet fluid prescribing practice varies much more widely than would be accepted for other drugs The inflammatory response generated by tissue injury causes complex changes in fluid and electrolyte balance. Although maintenance requirements are reduced, many patients require replacement of fluid losses Careful monitoring should be undertaken using clinical examination, fluid balance charts, and regular weighing when possible For most patients fluid losses during surgery can be replaced with resumption of oral fluid and light diet after surgery Patients undergoing complex major surgery (such as major gastrointestinal surgery, proximal femoral fracture repair) experience variable fluid losses due to tissue injury, inflammation, and blood loss. For these patients, evidence supports an individualised approach to fluid therapy often involving cardiac output monitoring during surgery Fluid restriction and diuresis may decrease oedema in patients with poor ventricular function but may increase the incidence of acute kidney injury. It is better to avoid excess fluid administration than to treat the consequences</p>