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Title: The Australian approach to peri-operative fluid balance.
Austin Authors: Glassford, Neil J;Myles, Paul S;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care Medicine, Austin Hospital, Australia
Issue Date: 1-Feb-2012
Publication information: Current Opinion in Anaesthesiology; 25(1): 102-10
Abstract: 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.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.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.
Gov't Doc #: 22113185
DOI: 10.1097/ACO.0b013e32834decd7
Journal: Current opinion in anaesthesiology
Type: Journal Article
Subjects: Australia
Fluid Therapy.methods
Perioperative Care.methods
Water-Electrolyte Balance
Appears in Collections:Journal articles

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