Meaning and Management of Perioperative Oliguria

Tallarico, Roberta Teixeira; McCoy, Ian E.; Dépret, Francois; Legrand, Matthieu

doi:10.1097/aln.0000000000004746

Cited by 5 publications

(1 citation statement)

References 52 publications

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“…Intraoperative oliguria occurring in isolation should not trigger fluid boluses since the predictive value for postoperative AKI appears low [65]. An institutional series of the Mayo Clinic revealed that a certain degree of postoperative hypotension in up to 10% of patients may persist for less than 20 h without negatively impacting AKI occurrence, which affected <3% [66].…”

Section: Fluid Management In the Perioperative Period: Which Indicatorsmentioning

confidence: 99%

Perioperative Fluid Management in Colorectal Surgery: Institutional Approach to Standardized Practice

Deslarzes,

Jurt,

Larson

et al. 2024

JCM

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The present review discusses restrictive perioperative fluid protocols within enhanced recovery after surgery (ERAS) pathways. Standardized definitions of a restrictive or liberal fluid regimen are lacking since they depend on conflicting evidence, institutional protocols, and personal preferences. Challenges related to restrictive fluid protocols are related to proper patient selection within standardized ERAS protocols. On the other hand, invasive goal-directed fluid therapy (GDFT) is reserved for more challenging disease presentations and polymorbid and frail patients. While the perfusion rate (mL/kg/h) appears less predictive for postoperative outcomes, the authors identified critical thresholds related to total intravenous fluids and weight gain. These thresholds are discussed within the available evidence. The authors aim to introduce their institutional approach to standardized practice.

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Section: Fluid Management In the Perioperative Period: Which Indicatorsmentioning

confidence: 99%

Perioperative Fluid Management in Colorectal Surgery: Institutional Approach to Standardized Practice

Deslarzes,

Jurt,

Larson

et al. 2024

JCM

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Goal-Directed Therapy in Liver Surgery

Marcus,

Syed,

Anderson

et al. 2024

Curr Anesthesiol Rep

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Purpose of Review This review summarizes the updated literature on goal-directed therapy during liver surgery. It provides guidance for clinicians regarding physiologic concepts and clinical evidence related to fluid and hemodynamic management strategies during and after liver resection. Recent Findings Open liver resection presents unique anatomic and physiologic challenges for the anesthesiologist. Care must be taken to reduce hemorrhage via control of inflow and outflow of hepatic blood. Resuscitation should be individualized to the patient and primarily utilize balanced crystalloids, blood products, and possibly albumin. Administration of intravenous fluids should be guided by hemodynamic parameters. Minimally invasive liver resection may be beneficial to patients but presents additional considerations for goal-directed therapy. Summary Goal-directed therapy can be utilized to decrease blood loss and optimize the surgical field during liver resection. This strategy holds promise to improve patient outcomes after liver surgery.

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Urinary oxygen tension and its role in predicting acute kidney injury: A narrative review

Wang,

Song,

Wang

et al. 2024

Journal of Clinical Anesthesia

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Meaning and Management of Perioperative Oliguria

Abstract: Perioperative oliguria is an alarm signal. The initial assessment includes closer patient monitoring, evaluation of volemic status, risk–benefit analysisof fluid challenge or furosemide stress test, and investigation of possible perioperative complications.

Cited by 5 publications

References 52 publications

Perioperative Fluid Management in Colorectal Surgery: Institutional Approach to Standardized Practice

Perioperative Fluid Management in Colorectal Surgery: Institutional Approach to Standardized Practice

Goal-Directed Therapy in Liver Surgery

Urinary oxygen tension and its role in predicting acute kidney injury: A narrative review

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