Perioperative Fluid Therapy
By: Robert G. Hahn (Editor), Donald S. Prough (Editor), Christer H. Svensen (Editor)
Hardcover | 6 September 2006 | Edition Number 1
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572 Pages
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Industry Reviews
"...Fluid management is one of the most important responsibilities of an anesthesiologist. While the topic has been covered in chapters in major texts, with additional material found scattered in isolated chapters, this book unifies the field. As such, it elevates the subject to the position it deserves."
-Doody's Review Services
Preface | p. iii |
Contributors | p. xiii |
Basic Science | |
Measurement of Body Fluid Volumes In Vivo | p. 1 |
Introduction: The Dilution Principle | p. 1 |
Anthropometry | p. 1 |
The Setting of the Operating Room | p. 2 |
Total Body Water | p. 3 |
Extracellular and Intracellular Water | p. 4 |
Blood Volume and Its Components | p. 6 |
Other Fluid Volume Measurements | p. 9 |
Summary and Conclusions | p. 9 |
References | p. 10 |
Microvascular Fluid Exchange | p. 13 |
Introduction | p. 13 |
Microvessels for Fluid Exchange | p. 13 |
Starling Equation for Transvascular Fluid Exchange | p. 15 |
The Three-Pore Model | p. 16 |
Autoregulation | p. 17 |
Hemodynamic Effects of Increased Permeability | p. 18 |
Microvascular Fluid Exchange in the Lung | p. 19 |
Microvascular Fluid Exchange in the Brain | p. 20 |
Intravascular Volume Substitution | p. 23 |
Crystalloid Infusion | p. 23 |
Colloid Infusion | p. 24 |
Erythrocyte Transfusion | p. 25 |
Hypertonic Solutions | p. 26 |
Permeability-Reducing Therapy | p. 26 |
References | p. 26 |
Methods of Assessing Fluid Balance | |
Invasive Hemodynamic Monitoring | p. 29 |
Practical Considerations of Fluid Management | p. 29 |
Pulmonary Artery Catheterization | p. 30 |
Intrathoracic Blood Volume Measurement | p. 33 |
Systolic Arterial Pressure Waveform Variability | p. 34 |
Transesophageal Echocardiography | p. 38 |
Esophageal Doppler Monitoring | p. 40 |
Conclusion | p. 42 |
References | p. 43 |
Oxygen Delivery as a Goal for Fluid Therapy in Surgical Patients | p. 49 |
Introduction | p. 49 |
Conventional Approach to Perioperative Fluid Therapy | p. 49 |
Basic Concepts | p. 50 |
The Relationship Between Oxygen Delivery and Oxygen Consumption | p. 51 |
Critical Oxygen Delivery During Surgery | p. 52 |
Oxygen Delivery and Infusion Fluids | p. 54 |
Conclusions About Optimal Perioperative Fluid Therapy | p. 58 |
Recommendations | p. 58 |
References | p. 59 |
Volume Kinetics | p. 63 |
"Effectiveness" of an Infusion Fluid | p. 63 |
Analyzing Hemoglobin Changes | p. 63 |
Hemoglobin Dilution During Surgery | p. 64 |
Drawbacks of Using Hemoglobin Dilution | p. 65 |
Volume Kinetics | p. 66 |
Future Challenges | p. 72 |
References | p. 73 |
Pulmonary Edema: Etiology and Measurement | p. 75 |
Background | p. 75 |
Clinical Aspects of Pulmonary Edema | p. 75 |
Theoretical Aspects of Pulmonary Edema | p. 76 |
Gas Exchange in Pulmonary Edema | p. 78 |
Measurement of Pulmonary Edema | p. 79 |
Conclusion | p. 83 |
References | p. 83 |
Intravascular Volume Assessment in the Critically Ill Patient | p. 87 |
Introduction | p. 87 |
Transesophageal Doppler Echocardiography | p. 87 |
Pulse Contour Analysis | p. 89 |
Respiration-Induced Changes | p. 90 |
Right Atrial Pressure | p. 90 |
Systemic Arterial Blood Pressure | p. 91 |
Chest Radiography | p. 92 |
Clinical Evaluation | p. 94 |
References | p. 95 |
Intravenous Fluids | |
Intravenous Access in Adults | p. 99 |
Peripheral Venous Access | p. 99 |
Central Venous Catheters | p. 102 |
References | p. 105 |
Vascular Access in Children | p. 107 |
Introduction | p. 107 |
Peripheral Venous Access | p. 107 |
Central Venous Access | p. 112 |
Pediatric Intravenous Equipment | p. 121 |
Arterial Cannulation | p. 122 |
Summary | p. 124 |
References | p. 125 |
Glucose Solutions | p. 129 |
Introduction | p. 129 |
Basic Needs for Glucose | p. 129 |
Glucose and the "Stress Response" | p. 130 |
Glucose and Insulin | p. 130 |
Glucose Levels During Surgery | p. 130 |
Indications and Contraindications for Glucose | p. 133 |
Conclusion | p. 134 |
References | p. 134 |
Crystalloid Solutions | p. 137 |
Introduction | p. 137 |
Physiological Principles | p. 138 |
Conventional Distribution of Fluid Volumes | p. 139 |
Kinetic Distribution of Fluid Volumes | p. 140 |
Crystalloid Solutions | p. 142 |
Surgical Procedures and Blood Loss | p. 145 |
Adverse Effects of Large-Volume Crystalloid Infusion | p. 146 |
Effects of Crystalloid Infusion on Immune Function | p. 147 |
Effects of Crystalloids on Acid-Base Balance | p. 147 |
Effects on Coagulation | p. 148 |
References | p. 148 |
Colloid Fluids | p. 153 |
Introduction | p. 153 |
Comparative Discussion of the Principal Colloids | p. 153 |
Specific Properties of Colloids | p. 156 |
Conclusion | p. 158 |
References | p. 159 |
Hypertonic Solutions | p. 163 |
History and Background | p. 163 |
Mechanisms of Hypertonic Solutions | p. 163 |
Clinical Use | p. 165 |
Adverse Effects | p. 168 |
Summary | p. 170 |
References | p. 170 |
Oxygen-Carrying Plasma Expanders: A New Class of Fluids for Perioperative Support | p. 175 |
Introduction | p. 175 |
Background | p. 175 |
Scientific and Clinical Challenges | p. 176 |
Products in Development | p. 176 |
Time Courses of Volume Expansion with Fluid Infusions | p. 178 |
Colloids and COP | p. 178 |
Relationships Between HBOC Volume Expansion and CO | p. 182 |
HBOCs as Resuscitative Fluids | p. 184 |
Conclusion and Recommendations | p. 184 |
References | p. 185 |
Intravenous Fluid Therapy in Special Situations | |
Hypovolemic Shock | p. 187 |
Introduction | p. 187 |
Etiology | p. 187 |
Physiological Response to Hypovolemia | p. 188 |
Pathophysiologic Response to Hypovolemia and Reperfusion Injury | p. 191 |
Conclusion and Future Developments | p. 194 |
References | p. 195 |
Septic Shock | p. 197 |
Introduction | p. 197 |
End Points of Resuscitation | p. 198 |
Choice of Fluids | p. 201 |
References | p. 203 |
Prehospital Fluid Therapy | p. 205 |
Introduction | p. 205 |
Continued Efforts | p. 205 |
Civilian Practice | p. 207 |
The Clinical Use of Hypertonic Solutions | p. 212 |
Other Aspects | p. 213 |
Recommendations | p. 214 |
References | p. 215 |
Fluid Therapy in Trauma | p. 221 |
Introduction | p. 221 |
Etiology of Shock in Acute Trauma | p. 221 |
Management Principles of Trauma-Related Shock | p. 223 |
Vascular Access and Flow Rates | p. 224 |
Hypotensive Resuscitation and Prehospital Fluids | p. 224 |
Crystalloids and Colloids: Isotonic Solutions | p. 225 |
Hypertonic Solutions | p. 227 |
Transfusions: Allogenic | p. 228 |
Autotransfusion: Autologous | p. 230 |
Autotransfusion | p. 231 |
Red Cell Substitutes | p. 231 |
Conclusion | p. 232 |
References | p. 232 |
Fluid Management in the Severely Burned Patient | p. 235 |
Introduction | p. 235 |
The Pathophysiology of Burn Shock | p. 235 |
Resuscitation of Burn Patients | p. 236 |
End Points of Resuscitation | p. 240 |
Conclusion | p. 244 |
References | p. 244 |
Perioperative Fluid Management of the Neurosurgical Patient | p. 247 |
Introduction | p. 247 |
Physical Principles Governing Fluid Movement Between the Intra- and Extravascular Spaces | p. 247 |
Characteristics of Intravenous Fluids | p. 250 |
General Principles of Neurosurgical Fluid Administration | p. 254 |
Monitoring Fluid Administration | p. 256 |
Fluid Administration in Specific Situations | p. 260 |
Common Perioperative Electrolyte Abnormalities in Neurosurgical Patients | p. 262 |
Summary | p. 265 |
References | p. 265 |
Fluid Therapy in the Intensive Care Unit | p. 269 |
Introduction | p. 269 |
Physiology | p. 269 |
Fluid Types, Characteristics, and Controversies | p. 271 |
Patient Assessment | p. 277 |
Practical Aspects of Fluid Management in the Intensive Care Unit | p. 278 |
Concluding Remarks | p. 284 |
References | p. 285 |
Transfusion of Red Cells and Blood Components in Stressed, Trauma, and Critical Care Patients | p. 289 |
Introduction | p. 289 |
Compensatory Mechanisms for Anemia and the Transfusion Decision in Trauma and Critical Care Patients | p. 289 |
Mixed Venous Oxygen Saturation | p. 292 |
What Is the Optimum Hb and Cardiac Output in the Trauma Patient? | p. 300 |
Use and Indications for Blood Transfusion in Trauma and Critically Ill Patients | p. 303 |
Complications of Blood Transfusion | p. 308 |
Indications for Platelets, FFP, and Cryoprecipitate in Bleeding Patients | p. 310 |
Conclusion | p. 313 |
References | p. 315 |
Fluid Management of Uncontrolled Hemorrhage | p. 321 |
Introduction | p. 321 |
Uncontrolled Hemorrhage | p. 321 |
Control of Hemorrhage | p. 322 |
End Points of Resuscitation | p. 323 |
Resuscitation During Active Hemorrhage | p. 323 |
Conclusions | p. 331 |
References | p. 331 |
Intravenous Fluid Therapy in Daily Practice | |
Spinal Anesthesia and Fluid Therapy | p. 333 |
Introduction | p. 333 |
Crystalloids | p. 333 |
Colloids | p. 335 |
Blood Pressure and Augmentation of Blood Volume | p. 337 |
Plasma Volume Expansion | p. 338 |
Regional Anesthesia and Physiology | p. 339 |
Venous Return and Mean Circulatory Filling Pressure | p. 341 |
Rapid Blood Volume Changes | p. 342 |
Summary | p. 344 |
References | p. 345 |
Fluid Balance in Day Surgery | p. 349 |
Day Surgery-A Growing Part of Modern Anesthesia | p. 349 |
Fluids: Fluid Balance in Day Surgery | p. 350 |
Conclusion | p. 354 |
References | p. 354 |
Intravenous Fluid Therapy in Daily Practice: Intraabdominal Operations | p. 357 |
Introduction | p. 357 |
Assessment of Fluid Requirement | p. 357 |
Fluid Shifts During Surgery | p. 357 |
Types of Fluid | p. 358 |
Transfusion of Blood and Blood Products | p. 360 |
Goal-Directed Therapy | p. 361 |
Conclusion | p. 362 |
References | p. 362 |
Fluid Therapy in Cardiac Surgery | p. 365 |
Introduction | p. 365 |
What Is So Special About Volume Therapy in Cardiac Surgery? | p. 365 |
Principles of Volume Replacement Therapy in Cardiac Surgery | p. 366 |
How to Perform Volume Therapy in Cardiac Surgery | p. 367 |
How to Monitor Volume Therapy in Cardiac Surgery | p. 371 |
Side Effects of Different Volume Replacement Strategies | p. 372 |
Economic Considerations | p. 374 |
Conclusion | p. 374 |
References | p. 374 |
Urology | p. 379 |
Introduction | p. 379 |
The Lithotomy Position | p. 379 |
Body Temperature | p. 379 |
Blood Lost in Irrigating Fluid | p. 380 |
Replacing Blood Lost During TURP | p. 381 |
Fluid Absorption in Urology | p. 382 |
Blood Loss in More Extensive Operations | p. 383 |
Indication for Transfusion of Erythrocytes | p. 384 |
Long-Term Mortality After Prostatectomy | p. 385 |
References | p. 385 |
Fluid Therapy in Noncardiac Thoracic Surgery | p. 389 |
Introduction | p. 389 |
Pulmonary Blood Flow, Drainage, and Physiology | p. 389 |
Postpneumonectomy Pulmonary Edema | p. 393 |
Fluid Management in Esophagectomy and Lung Transplant | p. 401 |
Conclusions | p. 402 |
References | p. 402 |
Fluid Management in Obstetrics | p. 405 |
Introduction | p. 405 |
Maternal Physiologic Changes of Pregnancy | p. 405 |
Maternal Physiologic Changes During the Peripartum Period | p. 406 |
Fluid Management During Labor and Vaginal Delivery | p. 407 |
Fluid Management for Obstetric Analgesia and Anesthesia | p. 408 |
Fluid Management for Labor Analgesia | p. 409 |
Fluid Management for Cesarean Section | p. 409 |
Fluid Management in Postpartum Patients | p. 413 |
Vasopressors in the Management of Regional Anesthesia-Induced Hypotension | p. 414 |
Fetal Response to Fluid Preload | p. 415 |
Fluid Management in Special Pregnancy States | p. 415 |
Conclusion | p. 417 |
References | p. 418 |
Perioperative Fluid Therapy in Pediatrics | p. 423 |
Introduction | p. 423 |
Physiology | p. 423 |
Maintenance Requirements | p. 424 |
Preoperative Assessment | p. 425 |
Intraoperative Fluid Management | p. 426 |
Volume Replacement During Infancy | p. 428 |
Postoperative Fluid Problems | p. 429 |
Conclusion | p. 430 |
References | p. 430 |
Restricted Intravenous Fluid Therapy in Elective Surgery | p. 435 |
Introduction | p. 435 |
The (Missing) Evidence for Current Fluid Therapy in Major Surgery | p. 436 |
The Replacement of Fluid Lost | p. 436 |
Trials of Goal-Directed Fluid Regimens (Standard Fluid vs. Extra Fluid) | p. 438 |
Trials on Restricted Intravenous Fluid Therapy | p. 442 |
Trials of Outpatient Surgery | p. 443 |
Recommendation: Restricted Intravenous Fluid Therapy in Major Elective Surgery | p. 445 |
References | p. 446 |
Adverse Effects of Fluids | |
Outcome Studies | p. 453 |
Introduction | p. 453 |
Albumin | p. 453 |
Crystalloid vs. Colloid Therapy | p. 454 |
Morbidity as the End Point | p. 455 |
Goal-Directed Fluid Therapy | p. 456 |
References | p. 457 |
Adverse Reactions to Infusion Fluids | p. 459 |
Introduction | p. 459 |
Local Adverse Effects | p. 459 |
Systemic Adverse Effects | p. 459 |
Conclusions | p. 471 |
References | p. 472 |
Absorption of Irrigating Fluid | p. 477 |
Introduction | p. 477 |
Sterile Water | p. 477 |
Glycine | p. 478 |
Mannitol | p. 478 |
Mixtures of Sorbitol and Mannitol | p. 480 |
Symptoms of Fluid Absorption | p. 480 |
Extravasation | p. 481 |
Assessment of Fluid Absorption | p. 482 |
Pathophysiology | p. 484 |
Mild and Severe TUR Syndromes | p. 484 |
Treatment | p. 484 |
References | p. 485 |
Effects of Perioperative Fluids on Acid-Base and Electrolyte Status | p. 489 |
Introduction | p. 489 |
Acid-Base Interpretation and Treatment | p. 489 |
Practical Approach to Acid-Base Interpretation | p. 495 |
Influence of Fluid Infusion on Serum Electrolytes | p. 498 |
Summary | p. 513 |
References | p. 513 |
Fluids and Coagulation | p. 517 |
Overview of Coagulation | p. 517 |
Overview of Intravenous Fluids and Coagulation | p. 517 |
Hemodilution and Coagulation | p. 519 |
Monitoring of Coagulation | p. 520 |
Perioperative Coagulation and DIC | p. 521 |
References | p. 522 |
Multiple Organ Failure | p. 525 |
Definitions Pertinent to Multiple Organ Failure | p. 525 |
The Historical Perspective of Postinjury Organ Failure and Death | p. 526 |
Epidemiology of Postinjury MOF | p. 528 |
Shock Is a Potential Modifiable Risk Factor | p. 528 |
Resuscitation Modulates Ischemia/Reperfusion-Induced SIRS | p. 528 |
References | p. 534 |
The Future of Intravenous Fluid Therapy | |
Perioperative Fluid Therapy: Predictions for the Future | p. 537 |
References | p. 541 |
Index | p. 543 |
Table of Contents provided by Ingram. All Rights Reserved. |
ISBN: 9780824728823
ISBN-10: 0824728823
Published: 6th September 2006
Format: Hardcover
Language: English
Number of Pages: 572
Audience: Professional and Scholarly
Publisher: Taylor & Francis Inc
Country of Publication: US
Edition Number: 1
Dimensions (cm): 17.2 x 26.0 x 3.12
Weight (kg): 1.13
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