Fluid Management, Volume Overload, and Gastrointestinal Tolerance in the Perioperative Period

Abstract This following is an extensive review of the practice of fluid administration in various medical and surgical disease states and the resilience of the intestinal track compared with other organ systems in maintaining preserved function in a fluid-overloaded state. Recent evidence supports a more conservative and even goal-directed fluid treatment strategy in cardiac, pulmonary, and septic medical conditions. However, the evidence is not as strong in favoring a restrictive versus a more liberal fluid strategy in several surgical specialties including general surgery and colorectal surgery. Despite the negative consequences of excessive fluid administration on the cardiopulmonary and gastrointestinal systems, enteral nutrition changes gene expression and increases intestinal aquaporin channels in edematous small bowel allowing tolerance.
Source: Current Surgery Reports - Category: Surgery Source Type: research