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Perioperatives Flüssigkeitsmanagement

Eine Analyse der aktuellen Studienlage

Perioperative fluid management

An analysis of the present situation

Der Anaesthesist volume 55, pages 371–390 (2006)Cite this article

Zusammenfassung

Das optimale perioperative Flüssigkeitsmanagement wird kontrovers diskutiert. Neben der häufig vorkommenden perioperativen Hypovolämie trägt auch die Hypervolämie entscheidend zur perioperativen Morbidität und Letalität bei, besonders im Hinblick auf verschiedene Krankheitsbilder, präexistente kardiale und pulmonale Funktionseinschränkungen und den operativen Eingriff an sich. Die Konzepte der prä, intra- und postoperativen Flüssigkeitsgabe sind weder ausreichend validiert, noch genügend in ein perioperatives Konzept integriert. Derzeit gelten moderate Flüssigkeitsgaben zur Verbesserung des prä- und postoperativen Wohlbefindens bei klein- bis mittelgroßen chirurgischen Eingriffen als gesichert. Hochrisikopatienten profitieren durch eine zeitgerechte und/oder zielgerichtete Flüssigkeitsgabe unter erweitertem Monitoring. Dem postoperativen Flüssigkeitsmanagement wurde bis dato nicht genügend Aufmerksamkeit geschenkt, aber es scheint durch die Konzepte der „Fast-track-Chirurgie“ neue Anregungen zu bekommen.

Abstract

Optimal perioperative fluid management is still controversial. Besides well known perioperative hypovolaemia, hypervolaemia has an influence on perioperative morbidity and mortality, particularly with regard to the patient’s medical history, a reduced cardiac and pulmonal function and the operation itself. The concepts of preoperative, intraoperative and postoperative fluid administration are neither adequately validated, nor sufficiently integrated into a perioperative concept. At the present, moderate fluid administration to improve preoperative and postoperative outcome is safe in minor or medium surgical procedures. High-risk surgical patients benefit from a time-oriented or/and goal-oriented monitored fluid therapy. In the past only little attention has been concentrated on postoperative fluid management, but may be stimulated by the new concepts of fast track surgery.

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Literatur

  1. Adrogue HJ, Madias NE (2000) Hypernatremia. N Engl J Med 342:1493–1499

    Article  PubMed  Google Scholar 

  2. Agarwal A, Chari P, Singh H (1989) Fluid deprivation before operation. The effect of a small drink. Anaesthesia 44:632–634

    PubMed  Google Scholar 

  3. Ali SZ, Taguchi A, Holtmann B et al. (2003) Effect of supplemental pre-operative fluid on postoperative nausea and vomiting. Anaesthesia 58:780–784

    Article  PubMed  Google Scholar 

  4. Allison SP, Lobo DN (2004) Fluid and electrolytes in the elderly. Curr Opin Clin Nutr Metab Care 7:27–33

    PubMed  Google Scholar 

  5. Andersson TR, Berner NS, Larsen ML et al. (1987) Plasma heparin cofactor II, protein C and antithrombin in elective surgery. Acta Chir Scand 153:291–296

    PubMed  Google Scholar 

  6. Apfel CC, Stoecklein K, Lipfert P (2005) PONV: a problem of inhalational anaesthesia? Best Pract Res Clin Anaesthesiol 19:485–500

    Article  PubMed  Google Scholar 

  7. Arieff AI (1999) Fatal postoperative pulmonary edema: pathogenesis and literature review. Chest 115:1371–1377

    Article  PubMed  Google Scholar 

  8. Arkilic CF, Taguchi A, Sharma N et al. (2003) Supplemental perioperative fluid administration increases tissue oxygen pressure. Surgery 133:49–55

    Article  PubMed  Google Scholar 

  9. Baig MK, Wexner SD (2004) Postoperative ileus: a review. Dis Colon Rectum 47:516–526

    Article  PubMed  Google Scholar 

  10. Balogh Z, McKinley BA, Cocanour CS et al. (2003) Supranormal trauma resuscitation causes more cases of abdominal compartment syndrome. Arch Surg 138:637–642

    Article  PubMed  Google Scholar 

  11. Bartels H, Stein HJ, Siewert JR (1998) Preoperative risk analysis and postoperative mortality of oesophagectomy for resectable oesophageal cancer. Br J Surg 85:840–844

    Article  PubMed  Google Scholar 

  12. Basse L, Hjort Jakobsen D, Billesbolle P et al. (2000) A clinical pathway to accelerate recovery after colonic resection. Ann Surg 232:51–57

    Article  PubMed  Google Scholar 

  13. Basse L, Billesbolle P, Kehlet H (2002) Early recovery after abdominal rectopexy with multimodal rehabilitation. Dis Colon Rectum 45:195–199

    Article  PubMed  Google Scholar 

  14. Basse L, Thorbol JE, Lossl K et al. (2004) Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum 47:271–277

    Article  PubMed  Google Scholar 

  15. Baxter CR, Shires T (1968) Physiological response to crystalloid resuscitation of severe burns. Ann N Y Acad Sci 150:874–894

    PubMed  Google Scholar 

  16. Bennett J, McDonald T, Lieblich S et al. (1999) Perioperative rehydration in ambulatory anesthesia for dentoalveolar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88:279–284

    Article  PubMed  Google Scholar 

  17. Berthoud MC, Reilly CS (1992) Adverse effects of general anaesthetics. Drug Saf 7:434–459

    PubMed  Google Scholar 

  18. Berwick DM (1991) Controlling variation in health care: a consultation from Walter Shewhart. Med Care 29:1212–1225

    PubMed  Google Scholar 

  19. Bisgaard T, Kristiansen VB, Hjortso NC et al. (2004) Randomized clinical trial comparing an oral carbohydrate beverage with placebo before laparoscopic cholecystectomy. Br J Surg 91:151–158

    Article  PubMed  Google Scholar 

  20. Bismuth H, Castaing D, Garden OJ (1989) Major hepatic resection under total vascular exclusion. Ann Surg 210:13–19

    PubMed  Google Scholar 

  21. Bokey EL, Chapuis PH, Fung C et al. (1995) Postoperative morbidity and mortality following resection of the colon and rectum for cancer. Dis Colon Rectum 38:480–486

    Article  PubMed  Google Scholar 

  22. Boldt J (2002) Aktuelle Perspektiven in der Volumenersatztherapie. Uni-Med, Bremen

  23. Boyd AD, Tremblay RE, Spencer FC et al. (1959) Estimation of cardiac output soon after intracardiac surgery with cardiopulmonary bypass. Ann Surg 150:613–626

    PubMed  Google Scholar 

  24. Boyd O (1999) Peri-operative cardiovascular optimization. Best Pract Res Clin Anaesthesiol 13:267–277

    Article  Google Scholar 

  25. Bradshaw BG, Liu SS, Thirlby RC (1998) Standardized perioperative care protocols and reduced length of stay after colon surgery. J Am Coll Surg 186:501–506

    Article  PubMed  Google Scholar 

  26. Brandstrup B, Tonnesen H, Beier Holgersen R et al. (2003) Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial. Ann Surg 238:641–648

    Article  PubMed  Google Scholar 

  27. Callum KG, Gray AJG, Hoile RW et al. (1999) Extremes of age: the 1999 Report of the National Confidential Enquiry into perioperative deaths. National Confidential Enquiry into Perioperative Deaths. London

    Google Scholar 

  28. Campbell IT, Baxter JN, Tweedie IE et al. (1990) IV fluids during surgery. Br J Anaesth 65:726–729

    PubMed  Google Scholar 

  29. Carmichael P, Carmichael AR (2003) Acute renal failure in the surgical setting. ANZ J Surg 73:144–153

    Article  PubMed  Google Scholar 

  30. Cartotto R, Choi J, Gomez M et al. (2003) A prospective study on the implications of a base deficit during fluid resuscitation. J Burn Care Rehabil 24:75–84

    Article  PubMed  Google Scholar 

  31. Chan ST, Kapadia CR, Johnson AW et al. (1983) Extracellular fluid volume expansion and third space sequestration at the site of small bowel anastomoses. Br J Surg 70:36–39

    PubMed  Google Scholar 

  32. Chandrashekar MV, Irving M, Wayman J et al. (2003) Immediate extubation and epidural analgesia allow safe management in a high-dependency unit after two-stage oesophagectomy. Results of eight years of experience in a specialized upper gastrointestinal unit in a district general hospital. Br J Anaesth 90:474–479

    Article  PubMed  Google Scholar 

  33. Claridge JA, Crabtree TD, Pelletier SJ et al. (2000) Persistent occult hypoperfusion is associated with a significant increase in infection rate and mortality in major trauma patients. J Trauma 48:8–14

    PubMed  Google Scholar 

  34. Clergue F, Auroy Y, Pequignot F et al. (1999) French survey of anesthesia in 1996. Anesthesiology 91:1509–1520

    Article  PubMed  Google Scholar 

  35. Clowes GH Jr, Guercio LR del (1960) Circulatory response to trauma of surgical operations. Metabolism 9:67–81

    PubMed  Google Scholar 

  36. Cohendy R, Brougere A, Cuvillon P (2005) Anaesthesia in the older patient. Curr Opin Clin Nutr Metab Care 8:17–21

    PubMed  Google Scholar 

  37. Conway DH, Mayall R, Abdul Latif MS et al. (2002) Randomised controlled trial investigating the influence of intravenous fluid titration using oesophageal Doppler monitoring during bowel surgery. Anaesthesia 57:845–849

    Article  PubMed  Google Scholar 

  38. Cook R, Anderson S, Riseborough M et al. (1990) Intravenous fluid load and recovery. A double-blind comparison in gynaecological patients who had day-case laparoscopy. Anaesthesia 45:826–830

    PubMed  Google Scholar 

  39. Cunningham JD, Fong Y, Shriver C et al. (1994) One hundred consecutive hepatic resections. Blood loss, transfusion, and operative technique. Arch Surg 129:1050–1056

    PubMed  Google Scholar 

  40. Desborough JP (2000) The stress response to trauma and surgery. Br J Anaesth 85:109–117

    Article  PubMed  Google Scholar 

  41. Dieterich HJ (2001) Kristalloide versus Kolloide. A never ending story? Anaesthesist 50:432–435

    Article  PubMed  Google Scholar 

  42. Dohrmann R (1959) Einfluss der Operation auf den Wasser-Elektrolythaushalt. In: Dohrmann R (Hrsg) Einführung in die prä- und postoperative Wasser- und Elektrolyttherapie. Springer, Berlin Göttingen Heidelberg, S 17–20

  43. Drummer C, Heer M, Baisch F et al. (1992) Diuresis and natriuresis following isotonic saline infusion in healthy young volunteers before, during, and after HDT. Acta Physiol Scand Suppl 604:101–111

    PubMed  Google Scholar 

  44. Eagle KA, Berger PB, Calkins H et al. (2002) ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery — Executive summary a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation 105:1257–1267

    PubMed  Google Scholar 

  45. Elhakim M, Sebiae S el, Kaschef N et al. (1998) Intravenous fluid and postoperative nausea and vomiting after day-case termination of pregnancy. Acta Anaesthesiol Scand 42:216–219

    PubMed  Google Scholar 

  46. Fasting S, Gisvold SE (2002) Serious intraoperative problems – A five-year review of 83,844 anesthetics. Can J Anaesth 49:545–553

    PubMed  Google Scholar 

  47. Fisher M (1977) Postoperative intravenous therapy. Anaesth Intensive Care 5:339–346

    PubMed  Google Scholar 

  48. Foster ME, Laycock JR, Silver IA et al. (1985) Hypovolaemia and healing in colonic anastomoses. Br J Surg 72:831–834

    PubMed  Google Scholar 

  49. Friedrich JB, Sullivan SR, Engrav LH et al. (2004) Is supra-Baxter resuscitation in burn patients a new phenomenon? Burns 30:464–466

    Article  PubMed  Google Scholar 

  50. Gan TJ, Soppitt A, Maroof M et al. (2002) Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology 97:820–826

    Article  PubMed  Google Scholar 

  51. Gilbert SS, Easy WR, Fitch WW (1995) The effect of pre-operative oral fluids on morbidity following anaesthesia for minor surgery. Anaesthesia 50:79–81

    PubMed  Google Scholar 

  52. Gluck SL (1998) Acid-base. Lancet 352:474–479

    Article  PubMed  Google Scholar 

  53. Goodwin AP, Rowe WL, Ogg TW et al. (1991) Oral fluids prior to day surgery. The effect of shortening the pre-operative fluid fast on postoperative morbidity. Anaesthesia 46:1066–1068

    PubMed  Google Scholar 

  54. Grocott MP, Mythen MG, Gan TJ (2005) Perioperative fluid management and clinical outcomes in adults. Anesth Analg 100:1093–1106

    Article  PubMed  Google Scholar 

  55. Gross CR, Lindquist RD, Woolley AC et al. (1992) Clinical indicators of dehydration severity in elderly patients. J Emerg Med 10:267–274

    Article  PubMed  Google Scholar 

  56. Grube C, Schaper N, Graf BM (2002) Man at risk. Aktuelle Strategien zum Risikomanagement in der Anästhesie. Anaesthesist 51:239–247

    Article  PubMed  Google Scholar 

  57. Hahn RG (1990) Fluid and electrolyte dynamics during development of the TURP syndrome. Br J Urol 66:79–84

    PubMed  Google Scholar 

  58. Hamilton-Davies C, Mythen MG, Salmon JB et al. (1997) Comparison of commonly used clinical indicators of hypovolaemia with gastrointestinal tonometry. Intensive Care Med 23:276–281

    Article  PubMed  Google Scholar 

  59. Harman D (2001) Aging: overview. Ann N Y Acad Sci 928:1–21

    PubMed  Google Scholar 

  60. Hartl WH, Rittler P (2002) Perioperative Infusionstherapie. Prinzipien. Chirurg 73:1067–1086

    Article  PubMed  Google Scholar 

  61. Hausel J, Nygren J, Lagerkranser M et al. (2001) A carbohydrate-rich drink reduces preoperative discomfort in elective surgery patients. Anesth Analg 93:1344–1350

    Article  PubMed  Google Scholar 

  62. Heyland DK, Cook DJ, King D et al. (1996) Maximizing oxygen delivery in critically ill patients: a methodologic appraisal of the evidence. Crit Care Med 24:517–524

    Article  PubMed  Google Scholar 

  63. Hillebrecht A, Schulz H, Meyer M et al. (1992) Pulmonary responses to lower body negative pressure and fluid loading during head-down tilt bedrest. Acta Physiol Scand Suppl 604:35–42

    PubMed  Google Scholar 

  64. Holte K, Kehlet H (2002) Compensatory fluid administration for preoperative dehydration – Does it improve outcome? Acta Anaesthesiol Scand 46:1089–1093

    Article  PubMed  Google Scholar 

  65. Holte K, Sharrock NE, Kehlet H (2002) Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth 89:622–632

    Article  PubMed  Google Scholar 

  66. Holte K, Jensen P, Kehlet H (2003) Physiologic effects of intravenous fluid administration in healthy volunteers. Anesth Analg 96:1504–1509, table of contents

    Article  PubMed  Google Scholar 

  67. Holte K, Klarskov B, Christensen DS et al. (2004) Liberal versus restrictive fluid administration to improve recovery after laparoscopic cholecystectomy: a randomized, double-blind study. Ann Surg 240:892–899

    Article  PubMed  Google Scholar 

  68. Hutchinson A, Maltby JR, Reid CR (1988) Gastric fluid volume and pH in elective inpatients. Part I: coffee or orange juice versus overnight fast. Can J Anaesth 35:12–15

    PubMed  Google Scholar 

  69. Janetzko K, Kluter H, Kirchner H et al. (2001) The effect of moderate hypovolaemia on microcirculation in healthy older blood donors. Anaesthesia 56:103–107

    Article  PubMed  Google Scholar 

  70. Jeng JC, Jablonski K, Bridgeman A et al. (2002) Serum lactate, not base deficit, rapidly predicts survival after major burns. Burns 28:161–166

    Article  PubMed  Google Scholar 

  71. Keane PW, Murray PF (1986) Intravenous fluids in minor surgery. Their effect on recovery from anaesthesia. Anaesthesia 41:635–637

    PubMed  Google Scholar 

  72. Kehlet H (1997) Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth 78:606–617

    PubMed  Google Scholar 

  73. Kern JW, Shoemaker WC (2002) Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med 30:1686–1692

    Article  PubMed  Google Scholar 

  74. Kirby RR (1999) Perioperative fluid therapy and postoperative pulmonary edema: cause-effect relationship? Chest 115:1224–1226

    Article  Google Scholar 

  75. Kita T, Mammoto T, Kishi Y (2002) Fluid management and postoperative respiratory disturbances in patients with transthoracic esophagectomy for carcinoma. J Clin Anesth 14:252–256

    Article  PubMed  Google Scholar 

  76. Lawlor PG (2002) Delirium and dehydration: some fluid for thought? Support Care Cancer 10:445–454

    Article  PubMed  Google Scholar 

  77. Leriche R (1934) La maladie postopératoire. Gaz Hopit 107:551

    Google Scholar 

  78. Licker M, Perrot M de, Spiliopoulos A et al. (2003) Risk factors for acute lung injury after thoracic surgery for lung cancer. Anesth Analg 97:1558–1565

    Article  PubMed  Google Scholar 

  79. Lobo DN (2004) Fluid, electrolytes and nutrition: physiological and clinical aspects. Proc Nutr Soc 63:453–466

    Article  PubMed  Google Scholar 

  80. Lobo DN (2004) Fluid and electrolytes in the clinical setting. Nestle Nutr Workshop Ser Clin Perform Programme 2004:187–198

    Google Scholar 

  81. Lobo DN, Dube MG, Neal KR et al. (2001) Problems with solutions: drowning in the brine of an inadequate knowledge base. Clin Nutr 20:125–130

    Article  PubMed  Google Scholar 

  82. Lobo DN, Bostock KA, Neal KR et al. (2002) Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial. Lancet 359:1812–1818

    Article  PubMed  Google Scholar 

  83. Lobo DN, Dube MG, Neal KR et al. (2002) Peri-operative fluid and electrolyte management: a survey of consultant surgeons in the UK. Ann R Coll Surg Engl 84:156–160

    PubMed  Google Scholar 

  84. Lowell JA, Schifferdecker C, Driscoll DF et al. (1990) Postoperative fluid overload: not a benign problem. Crit Care Med 18:728–733

    PubMed  Google Scholar 

  85. Macafee DA, Allison SP, Lobo DN (2005) Some interactions between gastrointestinal function and fluid and electrolyte homeostasis. Curr Opin Clin Nutr Metab Care 8:197–203

    PubMed  Google Scholar 

  86. Maharaj CH, Kallam SR, Malik A et al. (2005) Preoperative intravenous fluid therapy decreases postoperative nausea and pain in high risk patients. Anesth Analg 100:675–682, table of contents

    Article  PubMed  Google Scholar 

  87. Maltby JR, Sutherland AD, Sale JP et al. (1986) Preoperative oral fluids: is a five-hour fast justified prior to elective surgery? Anesth Analg 65:1112–1116

    PubMed  Google Scholar 

  88. Maltby JR, Reid CR, Hutchinson A (1988) Gastric fluid volume and pH in elective inpatients. Part II: Coffee or orange juice with ranitidine. Can J Anaesth 35:16–19

    PubMed  Google Scholar 

  89. McDonald GA, Dubose TD Jr (1993) Hyponatremia in the cancer patient. Oncology (Huntingt) 7:55–64

  90. Mecray PM, Barden RP, Ravdin IS (1990) Nutritional edema: its effect on the gastric emptying time before and after gastric operations. 1937. Nutrition 6:278–289

    PubMed  Google Scholar 

  91. Meiser A, Casagranda O, Skipka G et al. (2001) Quantifizierung von Blutverlusten. Wie genau ist visuelles Schätzen und wovon hängt die Genauigkeit ab? Anaesthesist 50:13–20

    Article  PubMed  Google Scholar 

  92. Melendez JA, Barrera R (1998) Predictive respiratory complication quotient predicts pulmonary complications in thoracic surgical patients. Ann Thorac Surg 66:220–224

    Article  PubMed  Google Scholar 

  93. Melendez JA, Arslan V, Fischer ME et al. (1998) Perioperative outcomes of major hepatic resections under low central venous pressure anesthesia: blood loss, blood transfusion, and the risk of postoperative renal dysfunction. J Am Coll Surg 187:620–625

    Article  PubMed  Google Scholar 

  94. Miller RD (2004) Anesthesia. Intravascular fluid and electrolyte physiology. In: Miller RD (2004) Miller’s anesthesia. Elsevier Churchill Livingstone. New York, pp 1763–1799

  95. Mittelstaedt H, Kerger H (2004) Perioperatives Management bei elektiven Leberresektionen. Anaesthesiol Intensivmed 45:403–413

    Google Scholar 

  96. Moore FD (1959) Metabolic care of the surgical patient. Saunders, Philadelphia

  97. Muller JM, Erasmi H, Stelzner M et al. (1990) Surgical therapy of oesophageal carcinoma. Br J Surg 77:845–857

    PubMed  Google Scholar 

  98. Mythen MG, Webb AR (1995) Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg 130:423–429

    PubMed  Google Scholar 

  99. Nahtomi-Shick O, Kostuik JP, Winters BD et al. (2001) Does intraoperative fluid management in spine surgery predict intensive care unit length of stay? J Clin Anesth 13:208–212

    Article  PubMed  Google Scholar 

  100. Nisanevich V, Felsenstein I, Almogy G et al. (2005) Effect of intraoperative fluid management on outcome after intraabdominal surgery. Anesthesiology 103:25–32

    Article  PubMed  Google Scholar 

  101. Oh MS, Kim HJ (2002) Basic rules of parenteral fluid therapy. Nephron 92 [Suppl 1]:56–59

    Google Scholar 

  102. Parquin F, Marchal M, Mehiri S et al. (1996) Post-pneumonectomy pulmonary edema: analysis and risk factors. Eur J Cardiothorac Surg 10:929–932

    Article  PubMed  Google Scholar 

  103. Pearson SD, Goulart Fisher D, Lee TH (1995) Critical pathways as a strategy for improving care: problems and potential. Ann Intern Med 123:941–948

    PubMed  Google Scholar 

  104. Perko MJ, Jarnvig IL, Hojgaard-Rasmussen N et al. (2001) Electric impedance for evaluation of body fluid balance in cardiac surgical patients. J Cardiothorac Vasc Anesth 15:44–48

    Article  PubMed  Google Scholar 

  105. Phillips PA, Bretherton M, Risvanis J et al. (1993) Effects of drinking on thirst and vasopressin in dehydrated elderly men. Am J Physiol 264:R877–881

    PubMed  Google Scholar 

  106. Phillips S, Hutchinson S, Davidson T (1993) Preoperative drinking does not affect gastric contents. Br J Anaesth 70:6–9

    PubMed  Google Scholar 

  107. Pickleman J, Watson W, Cunningham J et al. (1999) The failed gastrointestinal anastomosis: an inevitable catastrophe? J Am Coll Surg 188:473–482

    Article  PubMed  Google Scholar 

  108. Polanczyk CA, Rohde LE, Goldman L et al. (2001) Right heart catheterization and cardiac complications in patients undergoing noncardiac surgery: an observational study. JAMA 286:309–314

    Article  PubMed  Google Scholar 

  109. Price JD, Sear JW, Venn RM (2005) Perioperative fluid volume optimization following proximal femoral fracture. Cochrane Database Syst Rev Cd003004

  110. Prien T, Backhaus N, Pelster F et al. (1990) Effect of intraoperative fluid administration and colloid osmotic pressure on the formation of intestinal edema during gastrointestinal surgery. J Clin Anesth 2:317–323

    Article  PubMed  Google Scholar 

  111. Read MS, Vaughan RS (1991) Allowing pre-operative patients to drink: effects on patients‘ safety and comfort of unlimited oral water until 2 hours before anaesthesia. Acta Anaesthesiol Scand 35:591–595

    PubMed  Google Scholar 

  112. Rivers EP, Nguyen HB, Huang DT et al. (2004) Early goal-directed therapy. Crit Care Med 32:314–315

    Article  PubMed  Google Scholar 

  113. Ruchardt A, Lydtin H (1999) Storungen des Natrium- und Wasserhaushaltes. Diagnostik und Therapie. Internist (Berl) 40:W861–871

  114. Rusy BF, Komai H (1987) Anesthetic depression of myocardial contractility: a review of possible mechanisms. Anesthesiology 67:745–766

    PubMed  Google Scholar 

  115. Sanders G, Mercer SJ, Saeb Parsey K et al. (2001) Randomized clinical trial of intravenous fluid replacement during bowel preparation for surgery. Br J Surg 88:1363–1365

    Article  PubMed  Google Scholar 

  116. Sandham JD, Hull RD, Brant RF et al. (2003) A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 348:5–14

    Article  PubMed  Google Scholar 

  117. Scheidegger A, Lundsgaard Hansen P, Kupfer K et al. (1979) Hypoproteinämie als Ursache eines postoperativen „interstitiellen“ paralytischen Ileus. Chirurg 50:16–20

    PubMed  Google Scholar 

  118. Schultz RJ, Whitfield GF, LaMura JJ et al. (1985) The role of physiologic monitoring in patients with fractures of the hip. J Trauma 25:309–316

    PubMed  Google Scholar 

  119. Seinela L, Pehkonen E, Laasanen T et al. (2003) Bowel preparation for colonoscopy in very old patients: a randomized prospective trial comparing oral sodium phosphate and polyethylene glycol electrolyte lavage solution. Scand J Gastroenterol 38:216–220

    PubMed  Google Scholar 

  120. Shires GT 3rd, Peitzman AB, Albert SA et al. (1983) Response of extravascular lung water to intraoperative fluids. Ann Surg 197:515–519

    PubMed  Google Scholar 

  121. Shires T, Williams J, Brown F (1961) Acute change in extracellular fluids associated with major surgical procedures. Ann Surg 154:803–810

    PubMed  Google Scholar 

  122. Shirreffs SM (2000) Markers of hydration status. J Sports Med Phys Fitness 40:80–84

    PubMed  Google Scholar 

  123. Shoemaker WC, Appel PL, Kram HB et al. (1988) Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest 94:1176–1186

    PubMed  Google Scholar 

  124. Shoemaker WC, Appel PL, Kram HB (1993) Hemodynamic and oxygen transport responses in survivors and nonsurvivors of high-risk surgery. Crit Care Med 21:977–990

    PubMed  Google Scholar 

  125. Sinclair S, James S, Singer M (1997) Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ 315:909–912

    PubMed  Google Scholar 

  126. Slinger PD (1995) Perioperative fluid management for thoracic surgery: the puzzle of postpneumonectomy pulmonary edema. J Cardiothorac Vasc Anesth 9:442–451

    Article  PubMed  Google Scholar 

  127. Spencer EM (1988) Intravenous fluids in minor gynaecological surgery. Their effect on postoperative morbidity. Anaesthesia 43:1050–1051

    PubMed  Google Scholar 

  128. Spies CD, Breuer JP, Gust R et al. (2003) Präoperative Nahrungskarenz. Ein Update. Anaesthesist 52:1039–1045

    Article  PubMed  Google Scholar 

  129. Splinter WM, Schaefer JD (1991) Ingestion of clear fluids is safe for adolescents up to 3 h before anaesthesia. Br J Anaesth 66:48–52

    PubMed  Google Scholar 

  130. Stephens R, Mythen M (2003) Optimizing intraoperative fluid therapy. Curr Opin Anaesthesiol 16:385–392

    Article  Google Scholar 

  131. Stone JG, Hoar PF, Khambatta HJ (1983) Influence of volume loading on intraoperative hemodynamics and perioperative fluid retention in patients with valvular regurgitation undergoing prosthetic replacement. Am J Cardiol 52:530–533

    Article  PubMed  Google Scholar 

  132. Stoneham MD, Hill EL (1997) Variability in post-operative fluid and electrolyte prescription. Br J Clin Pract 51:82–84

    PubMed  Google Scholar 

  133. Sun X, Iles M, Weissman C (1993) Physiologic variables and fluid resuscitation in the postoperative intensive care unit patient. Crit Care Med 21:555–561

    PubMed  Google Scholar 

  134. Takala J, Meier Hellmann A, Eddleston J et al. (2000) Effect of dopexamine on outcome after major abdominal surgery: a prospective, randomized, controlled multicenter study. European Multicenter Study Group on Dopexamine in Major Abdominal Surgery. Crit Care Med 28:3417–3423

    Article  PubMed  Google Scholar 

  135. Tremblay LN, Feliciano DV, Rozycki GS (2002) Assessment of initial base deficit as a predictor of outcome: mechanism of injury does make a difference. Am Surg 68:689–693

    PubMed  Google Scholar 

  136. Turnage WS, Lunn JJ (1993) Postpneumonectomy pulmonary edema. A retrospective analysis of associated variables. Chest 103:1646–1650

    PubMed  Google Scholar 

  137. Venn R, Steele A, Richardson P et al. (2002) Randomized controlled trial to investigate influence of the fluid challenge on duration of hospital stay and perioperative morbidity in patients with hip fractures. Br J Anaesth 88:65–71

    Article  PubMed  Google Scholar 

  138. Verheijen Breemhaar L, Bogaard JM, Berg B van den et al. (1988) Postpneumonectomy pulmonary oedema. Thorax 43:323–326

    PubMed  Google Scholar 

  139. Voelckel WG, Goedecke A von, Fries D et al. (2004) Die Behandlung des hämorrhagischen Schocks. Neue Therapieoptionen. Anaesthesist 53:1151–1167

    Article  PubMed  Google Scholar 

  140. Wakeling HG, McFall MR, Jenkins CS et al. (2005) Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth 95:634–642

    Article  PubMed  Google Scholar 

  141. Walsh SR, Walsh CJ (2005) Intravenous fluid-associated morbidity in postoperative patients. Ann R Coll Surg Engl 87:126–130

    Article  PubMed  Google Scholar 

  142. Wiebalck A, Moellhoff T, Hachenberg T et al. (2002) Perioperative Optimierung des Sauerstoffangebotes bei Hochrisikopatienten. Anaesthesiol Intensivmed 43:327–339

    Google Scholar 

  143. Wilkinson AW, Billing BH, Nagy G et al. (1950) Excretion of potassium after partial gastrectomy. Lancet 2:135–137

    Article  PubMed  Google Scholar 

  144. Williams EL, Hildebrand KL, McCormick SA et al. (1999) The effect of intravenous lactated Ringer’s solution versus 0.9% sodium chloride solution on serum osmolality in human volunteers. Anesth Analg 88:999–1003

    Article  PubMed  Google Scholar 

  145. Wilson J, Woods I, Fawcett J et al. (1999) Reducing the risk of major elective surgery: randomised controlled trial of preoperative optimisation of oxygen delivery. BMJ 318:1099–1103

    PubMed  Google Scholar 

  146. Woods MS, Kelley H (1993) Oncotic pressure, albumin and ileus: the effect of albumin replacement on postoperative ileus. Am Surg 59:758–763

    PubMed  Google Scholar 

  147. Yogendran S, Asokumar B, Cheng DC et al. (1995) A prospective randomized double-blinded study of the effect of intravenous fluid therapy on adverse outcomes on outpatient surgery. Anesth Analg 80:682–686

    Article  PubMed  Google Scholar 

  148. Zink W, Graf BM (2003) Toxikologie der Lokalanästhetika. Pathomechanismen – Klinik – Therapie. Anaesthesist 52:1102–1123

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. ZARI – Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsklinikum, Georg-August-Universität, Göttingen

    Y. A. Zausig & B. M. Graf

  2. Klinik für Anaesthesiologie, Universitätsklinikum, Ruprecht-Karls-Universität, Heidelberg

    M. A. Weigand

  3. ZARI – Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität, Robert-Koch-Straße 40, 37075, Göttingen

    Y. A. Zausig

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  1. Y. A. Zausig
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  2. M. A. Weigand
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  3. B. M. Graf
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Correspondence to Y. A. Zausig.

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Zausig, Y.A., Weigand, M.A. & Graf, B.M. Perioperatives Flüssigkeitsmanagement. Anaesthesist 55, 371–390 (2006). https://doi.org/10.1007/s00101-006-0988-5

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  • DOI: https://doi.org/10.1007/s00101-006-0988-5

Schlüsselwörter

  • Perioperatives Flüssigkeitsmanagement
  • Hypovolämie
  • Hypervolämie
  • Morbidität
  • Letalität

Keywords

  • Perioperative fluid management
  • Hypovolaemia
  • Hypervolaemia
  • Morbidity
  • Mortality