Abstract:
Proper perioperative fluid management is the most important aspect governing haemo
dynamic function in a surgical patient. Maintenance of sufficient intravascular volume is of
paramount importance.
There is a large variability in the fluid regimens in daily practice and their implications for
outcome in elective surgery are controversial.
Recent randomised trials in major abdominal surgery suggest liberal fluid administration
would affect cardio respiratory function, reduce gut motility, reduce tissue oxygenation
thereby affecting would healing and lead to increased morbidity and hospital stay. It is well
established with evidence in thoracic surgical circles of liberal fluid regimens contributing
to poor outcomes after lung surgery. There is growing support for this view in the general
surgical population with growing literature -comparing liberal with restrictive fluid
management many of which show better outcomes in fluid restricted patients.
Opponents of both regimens argue that our aim should be not liberal, not restrictive, based
on volumes but "goal directed" towards monitored parameters.
