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|Title:||The Australian approach to peri-operative fluid balance|
|ANZCA/FPM Author:||Myles, PS|
|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.|
|Study Name:||NCT01424150: REstrictive Versus LIbEral Fluid Therapy in Major Abdominal Surgery: RELIEF Study (RELIEF)|
|Journal Title:||Current Opinion in Anesthesiology|
|Appears in Collections:||Scholarly and Clinical|
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