Fluid management for enhanced recovery surgery

Katy O’Rourke, Ben Morrison, Soumen Sen, Chris Jones

Abstract

This review article introduces some of the major concepts in perioperative fluid management and the application of these to enhanced recovery programmes (ERPs). The aim of these programmes are to implement multimodal pathways in the perioperative period in order to reduce the risk of perioperative organ dysfunction and morbidity. This article introduces some of the concepts that should be considered during ERPs in terms of perioperative fluid administration, based upon the latest recommendations and guidelines produced internationally. Inappropriate fluid management can lead to increased morbidity, increased length of stay and can have costly implications for healthcare providers. Overall concepts of fluid management include maintenance of homeostasis and euvolaemia. We have looked at how to implement this for patients in preoperative, intraoperative and postoperative states. This article is based upon recent guidelines and consensus statements published internationally. Despite the generalised concepts behind fluid administration in ERPs, patients should continue to have individualised management plans based upon their specific health requirements.