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Title: The Australian approach to peri-operative fluid balance
Authors: Glasford, NJ
Myles, PS 
Bellomo, R
Keywords: RELIEF
Issue Date: Feb-2012
Source: 25(1):102-10.
Abstract: PURPOSE OF REVIEW: The role of fluid balance as an important contributor to patient morbidity and mortality in the peri-operative period is only now being understood. Numerous studies in disparate populations undergoing different surgeries suggest that. RECENT FINDINGS: There is wide disparity in fluid administration regimen between speciality, country, and clinician. Recent meta-analyses of published studies have shown that restrictive fluid administration strategies may improve patient-centred outcomes when compared to liberal regimens. Current evidence suggests a significant role for fluid accumulation in the development of peri-operative complications. Fluid balance is best achieved using goal-directed techniques. The evidence base is, at present, sub-optimal, with a paucity of level 1 evidence for clinical decision-making. SUMMARY: In the absence of level 1 evidence it is difficult to make firm recommendations about practice, though observational and single-centre data suggest a significant survival advantage may be conferred by the peri-operative administration of fluids to monitored physiological targets only. The Australian approach to peri-operative fluid management is to create level 1 evidence. To this end, the development of a large multicentre randomized controlled trial of peri-operative fluid administration is underway.
DOI: 10.1097/ACO.0b013e32834decd7
PubMed URL:
Study Name: NCT01424150: REstrictive Versus LIbEral Fluid Therapy in Major Abdominal Surgery: RELIEF Study (RELIEF)
Journal Title: Current Opinion in Anesthesiology
Type: Journal Article
Study/Trial: Reviews/Systematic Reviews
Appears in Collections:Scholarly and Clinical

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