Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Minerva Anestesiologica 2017 June;83(6) > Minerva Anestesiologica 2017 June;83(6):652-9

ULTIMO FASCICOLO
 

ARTICLE TOOLS

Publication history
Estratti
Per citare questo articolo

MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


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 2,623


eTOC

 

REVIEW  FREEfree


Minerva Anestesiologica 2017 June;83(6):652-9

DOI: 10.23736/S0375-9393.17.11760-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Fluid management in thoracic anesthesia

Mert ŞENTÜRK , Mukadder ORHAN SUNGUR, Zerrin SUNGUR

Department of Anesthesiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey


FULL TEXT  


Fluid management during thoracic anesthesia remains as a challenge for the anesthesiologists. The “safe zone” between volume overload (risk of pulmonary edema) and hypovolemia (potential risk of renal failure) is hard to determine and narrow. Relationship between perioperative fluid administration and postoperative lung injury has been clearly demonstrated but lung injury can even occur after the most restrictive management. Multiple hit hypothesis and endothelial glycocalyx in addition to revised Starling equation can help us understand this dilemma. Although a “liberal” fluid strategy is out of question for thoracic surgery, evidence on “restrictive” and “goal-directed” fluid strategies are missing. New monitors with dynamic parameters can help to evaluate if the patient will respond to a fluid challenge. However, “volume responsiveness” should not be equated with volume deficiency, especially in a patient with thoracic epidural catheter. Fluid type (crystalloids or colloids) is also another unclear point, although balanced solutions should be preferred for crystalloids. Minimal discontinuation of oral hydration, early feeding and mobilization should be encouraged. This review summarizes current evidence on the topic and highlights unanswered questions.


KEY WORDS: Intravenous anesthesia - Colloids - Thoracic surgery - Anesthesia - Lung injury

inizio pagina

Publication History

Issue published online: June 7, 2017
Article first published online: January 25, 2017
Manuscript accepted: January 10, 2017
Manuscript revised: January 4, 2017
Manuscript received: October 17, 2016

Per citare questo articolo

Şentürk M, Orhan Sungur M, Sungur Z. Fluid management in thoracic anesthesia. Minerva Anestesiol 2017;83:652-9. DOI: 10.23736/S0375-9393.17.11760-8

Corresponding author e-mail

senturkm@istanbul.edu.tr