Changing practices of fluid therapy

Hahn, Robert G.

doi:10.1111/aas.12892

Acta Anaesthesiol Scand

2017

DOI: 10.1111/aas.12892

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Changing practices of fluid therapy

Robert G. Hahn

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Cited by 3 publications

(1 citation statement)

References 26 publications

(25 reference statements)

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“…Despite this, Hahn highlights that N-Sal remains the dominating crystalloid fluid used in Scandinavia and throughout Europe. 3 Furthermore, when focusing on perioperative crystalloid use, there is concern surrounding the effect of slightly hypotonic HS on cerebral water content in neurosurgical patients in comparison to isotonic saline. A previous systematic review has concluded that buffered fluids are a safe and effective alternative to saline based fluids for administration to adults during surgery.…”

mentioning

confidence: 99%

Perioperative fluid administration and effect on physiology and biochemistry of patients undergoing neurosurgical procedures

Eaton

McCarthy

Jürgens

2017

Acta Anaesthesiol Scand

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mentioning

confidence: 99%

Perioperative fluid administration and effect on physiology and biochemistry of patients undergoing neurosurgical procedures

Eaton

McCarthy

Jürgens

2017

Acta Anaesthesiol Scand

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In response: fluids in neurosurgery

Hahn

2017

Acta Anaesthesiol Scand

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Anesthesia-Associated Relative Hypovolemia: Mechanisms, Monitoring, and Treatment Considerations

Noel-Morgan

Muir

2018

Front. Vet. Sci.

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Although the utility and benefits of anesthesia and analgesia are irrefutable, their practice is not void of risks. Almost all drugs that produce anesthesia endanger cardiovascular stability by producing dose-dependent impairment of cardiac function, vascular reactivity, and compensatory autoregulatory responses. Whereas anesthesia-related depression of cardiac performance and arterial vasodilation are well recognized adverse effects contributing to anesthetic risk, far less emphasis has been placed on effects impacting venous physiology and venous return. The venous circulation, containing about 65–70% of the total blood volume, is a pivotal contributor to stroke volume and cardiac output. Vasodilation, particularly venodilation, is the primary cause of relative hypovolemia produced by anesthetic drugs and is often associated with increased venous compliance, decreased venous return, and reduced response to vasoactive substances. Depending on factors such as patient status and monitoring, a state of relative hypovolemia may remain clinically undetected, with impending consequences owing to impaired oxygen delivery and tissue perfusion. Concurrent processes related to comorbidities, hypothermia, inflammation, trauma, sepsis, or other causes of hemodynamic or metabolic compromise, may further exacerbate the condition. Despite scientific and technological advances, clinical monitoring and treatment of relative hypovolemia still pose relevant challenges to the anesthesiologist. This short perspective seeks to define relative hypovolemia, describe the venous system’s role in supporting normal cardiovascular function, characterize effects of anesthetic drugs on venous physiology, and address current considerations and challenges for monitoring and treatment of relative hypovolemia, with focus on insights for future therapies.

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Changing practices of fluid therapy

Cited by 3 publications

References 26 publications

Perioperative fluid administration and effect on physiology and biochemistry of patients undergoing neurosurgical procedures

Perioperative fluid administration and effect on physiology and biochemistry of patients undergoing neurosurgical procedures

In response: fluids in neurosurgery

Anesthesia-Associated Relative Hypovolemia: Mechanisms, Monitoring, and Treatment Considerations

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