Parenteral fluid administration beneath the fascia lata

Finley, Robert K.; Shaffer, James M.; Altenberg, Alfons

doi:10.1016/s0002-9610(44)90370-3

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…A previous study reported that the average absorption time of 1 L of isotonic fluid in the medial thigh of 33 patients was 167 minutes. [ 11 ] Fluid extravasations and stasis followed by suction trauma reduces urine output. Compressive garments during postoperative recovery room further aided in promoting the shift of subcutaneous fluid into the intravascular space and led to the second peak in urine output, which was also observed in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Fluid management in extensive liposuction

2018

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Tumescent anesthesia makes it feasible to perform liposuction in an office setting. There are often patients who desire extensive liposuction on approximately 30% of total body surface area, which means the potential of fluid overload. In this study, the charts of 83 patients undergoing extensive liposuction were retrospectively reviewed. The intra-operative fluid ratio was 1.66 for the extensive liposuction. There were no episodes of pulmonary edema, congestive heart failure exacerbation, or other major complications. The average urine output in the operating room, the recovery room, and while on the floors was 1.35, 2.3, and 1.4 mL/kg/hour respectively. Intravenous (IV) fluid administration during operation was minimized to approximately 300 to 500 mL. The total volume of IV injection was also reduced to less than 1500 mL when the patient was in the recovery room and on the hospital floor. Our fluid management strategy in extensive liposuction reflects minimal risk of volume overload. Foley catheters are not applied and patients could resume oral intake in usual, so they can discharge after 6 hours of recovery room stay in our daily practice.

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Section: Discussionmentioning

confidence: 99%

Fluid management in extensive liposuction

2018

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Intramuscular infusions of protein hydrolysate

Weinstein¹

1949

The American Journal of Surgery

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Safety Considerations and Fluid Resuscitation in Liposuction: An Analysis of 53 Consecutive Patients

Trott

Beran

Rohrich

et al. 1998

Plastic and Reconstructive Surgery

122

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There is no agreement as to appropriate fluid resuscitation in patients undergoing liposuction. This has assumed greater significance, as surgeons have undertaken larger volume aspirations (> or = 4 liters) and the potential complications of hypovolemia and fluid overload have materialized. This prospective study of 53 consecutive healthy patients undergoing liposuction using a superwet technique served to develop general guidelines for safe perioperative fluid management, especially in regard to large-volume aspirations. In this context, "aspirate" is defined as the total fat and fluid that is removed during liposuction. All patients were monitored using standard noninvasive hemodynamic monitoring. Thirty-six patients were monitored perioperatively with Foley catheters. The 53 patients underwent liposuction alone. We did not include patients who underwent concurrent aesthetic surgical procedures because our intention was to establish fluid administration guidelines for the liposuction patient. There were no significant complications in our series. The intraoperative fluid ratio, defined as (intravenous fluid + infiltrate)/aspirate, was 2.1 for the small-volume group and 1.4 for the large-volume group. These values were significantly different (p < .001, t test). Average urine output in the operating room and recovery room and on the floor was satisfactory (> 0.5 to 1 cc/kg/hr) and did not relate to volume aspirated (p = 0.21, 0.91, and 0.6, respectively, t test). Four patients who underwent "large-volume" aspirations (> or = 4 liters) had transient hypotension, which was immediately responsive to crystalloid fluid boluses in the first postoperative hours. All other patients required only maintenance intravenous crystalloid postoperatively until oral intake had been resumed. There were no statistically significant differences in postoperative fluid administration between the small- and large-volume groups. Ninety-three percent of patients were discharged within 24 hours of surgery. Our suggested guidelines for fluid resuscitation based on this retrospective study are as follows: (1) small volume (< 4 liters aspirated): maintenance fluid + subcutaneous wetting solution; (2) large volume (> or = 4 liters aspirated): maintenance fluid + subcutaneous wetting solution + 0.25 cc of intravenous crystalloid per cc of aspirate removed after 4 liters. This formula has since been used in the care of 94 patients who have undergone liposuction exclusively. All patients have had unremarkable hospital courses. These guidelines do not replace sound clinical judgment. Good communication between the surgeon and anesthesiologist is critical to optimal patient care and safety.

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Parenteral fluid administration beneath the fascia lata

Cited by 3 publications

References 9 publications

Fluid management in extensive liposuction

Fluid management in extensive liposuction

Intramuscular infusions of protein hydrolysate

Safety Considerations and Fluid Resuscitation in Liposuction: An Analysis of 53 Consecutive Patients

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