Fluid Management and Blood Transfusion
“Fluid or no fluid?” This is a recurring question confronting anesthesiologists caring for patients in the perioperative settings. Some of the triggers for this query include preoperative fasting state, intraoperative hypotension, and postoperative oliguria. Controversy continues regarding how clinicians should assess volume status and determine end points of fluid therapy. Blood transfusion is often equally controversial, with few exceptions. Issues surrounding fluid and blood products are especially complex in the aged patient. In this chapter, fluid management and blood transfusion therapy in the context of care of the geriatric patient will be addressed.
KeywordsGeriatric Patient Fluid Responsiveness Total Body Water Fluid Management Pulse Pressure Variation
- Kelleher CL. Disorders of water and electrolyte metabolism. In: Tallis R, Fillit H, eds. Brocklehurst’s textbook of geriatric medicine and gerontology. 6th ed. London: Churchill Livingstone; 2003:1109–17.Google Scholar
- Perel P, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. 2007:CD000567.Google Scholar
- Wiggins J. Changes in renal function. In: Hazzard WR, Blass JP, Halter JB, Ouslander JG, Tinetti ME, eds. Principles of geriatric medicine and gerontology. 5th ed. New York: McGraw-Hill/Professional; 2003:543–9.Google Scholar
- Zimmermann M, Feibicke T, Keyl C, et al. Accuracy of stroke volume variation compared with pleth variability index to predict fluid responsiveness in mechanically ventilated patients undergoing major surgery. Eur J Anaesthesiol. 2010;27(6):555–61.Google Scholar