Home > Journals > Minerva Anestesiologica > Past Issues > Minerva Anestesiologica 2015 July;81(7) > Minerva Anestesiologica 2015 July;81(7):794-807

CURRENT ISSUEMINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036


eTOC

 

REVIEWS  


Minerva Anestesiologica 2015 July;81(7):794-807

language: English

Targets of perioperative fluid therapy and their effects on postoperative outcome: a systematic review and meta-analysis

Berger M. M. 1, Gradwohl-Matis I. 1, Brunauer A. 1, Ulmer H. 2, Dünser M. W. 1

1 Department of Anesthesiology, Perioperative Medicine and General Intensive Care, University Hospital Salzburg and Paracelsus Private Medical University, Salzburg, Austria;
2 Department of Medical Statistics, Informatics and Health Economics, Innsbruck, Austria


FULL TEXT  REPRINTS


Perioperative fluid management plays a fundamental role in maintaining organ perfusion, and is considered to affect morbidity and mortality. Targets according to which fluid therapy should be administered are poorly defined. This systematic review aimed to identify specific targets for perioperative fluid therapy. The PubMed database (January 1993-December 2013) and reference lists were searched to identify clinical trials which evaluated specific targets of perioperative fluid therapy and reported clinically relevant perioperative endpoints in adult patients. Only studies in which targeted fluid therapy was the sole intervention were included into the main data analysis. A pooled data analysis was used to compare mortality between goal-directed fluid therapy and control interventions. Thirty-six clinical studies were selected. Sixteen studies including 1224 patients specifically evaluated targeted fluid therapy and were included into the main data analysis. Three specific targets for perioperative fluid therapy were identified: a systolic or pulse pressure variation <10-12%, an increase in stroke volume <10%, and a corrected flow time of 0.35-0.4 s in combination with an increase in stroke volume <10%. Targeting any one of these goals resulted in less postoperative complications (pooled data analysis: OR 0.53; CI95, 0.34-0.83; P=0.005) and a shorter length of intensive care unit/hospital stay, but no difference in postoperative mortality (pooled data analysis: OR 0.61; CI95, 0.33-1.11; P=0.12). This systematic review identified three goals for perioperative fluid administration, targeting of which appeared to be associated with less postoperative complications and shorter intensive care unit/hospital lengths of stay. Perioperative mortality remained unaffected.

top of page