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Available online 16 September 2024
Use of fluid therapy in perioperative adult patients: A narrative review
Uso de fluidoterapia en el periodo perioperatorio en pacientes adultos: revisión narrativa
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M.J. Colominaa,b,c, P. Galán Menéndezc,d, J. Ripollés-Melchorc,d,
Corresponding author
ripo542@gmail.com

Corresponding author.
a Department of Anesthesia, Critical Care and Pain Clinic, Bellvitge University Hospital, University of Barcelona-Campus de la Salud, IDIBELL, Barcelona, Spain
b Department of Anesthesia, Critical Care and Pain Clinic, Vall d’Hebron University Hospital, Barcelona, Spain
c Anesthesia and Critical Care Department, Infanta Leonor University Hospital, Madrid, Spain
d Universidad Complutense de Madrid, Madrid, Spain
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Received 30 December 2023. Accepted 09 April 2024
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Table 1. Characteristics of the principle crystalloids used in clinical practice.1,3,7,45–49
Table 2. Main characteristics of the studies included in this narrative review (in order of appearance in the text).
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Abstract

The administration of intravenous fluids is the most common intervention in hospitalised patients in the perioperative setting and critical care units. The aim of this narrative review is to provide an overview of balanced solutions for fluid therapy in the perioperative period in adult patients, and to review new trends and solutions in fluid therapy.

The evidence was grouped into 3 areas: intraoperative fluid administration, fluid administration in critically ill patients, and the importance / benefit of balanced crystalloid solutions.

Although a number of high-quality studies have been published in recent years, the scientific evidence regarding the type of fluid, the dose, and rate of administration is still limited. The choice of fluid therapy during the perioperative period must be tailored to patient-specific factors, the nature of the surgery, expected fluid loss, and other relevant factors. Finally, more robust clinical evidence and physician training is of the utmost importance.

Keywords:
Fluid therapy
Intravenous fluid
Lactate
Acetate
Balanced crystalloids
Critical illness
Abbreviations:
AKI
RA
RCT
RL
RRT
SID
SS
Resumen

La administración de líquidos intravenosa es la intervención más común en los pacientes hospitalizados en el ámbito perioperatorio y las unidades de cuidados críticos. El objetivo de esta revisión narrativa es aportar una visión general de las soluciones balanceadas en fluidoterapia en el periodo perioperatorio en pacientes adultos, así como revisar las nuevas tendencias y soluciones de la fluidoterapia.

Se agrupó la evidencia en 3 áreas: administración intraoperatoria de líquidos, administración de líquidos en pacientes críticos y relevancia/beneficio de las soluciones de cristaloides balanceadas.

Aunque en los últimos años se ha producido una mejora de los estudios de gran calidad publicados, la evidencia científica en cuanto a la elección de los líquidos, así como sus dosis y tasa de administración sigue siendo limitada. Debe individualizarse la elección de fluidoterapia durante el periodo perioperatorio, considerando los factores específicos del paciente, la naturaleza de la cirugía, la pérdida de sangre prevista y otros factores relevantes. Por último, deberá ser de máxima importancia la evidencia clínica robusta y la formación de los facultativos.

Palabras clave:
Fluidoterapia
Líquidos intravenosos
Lactato
Acetato
Cristaloides balanceados
Enfermedad crítica

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