2017 Volume 37 Issue 2 Pages 219-224
Appropriate perioperative fluid management, especially in Goal-Directed Therapy（GDT）, plays an important role in Enhanced Recovery after Surgery（ERAS）. Some systematic reviews have suggested that perioperative GDT decreases postoperative complications such as infection, respiratory and bowel function and hospital stay, but recent multi-center randomized controlled studies arrived at different conclusions. The overall goal of perioperative GDT is to maintain central euvolemia and avoid excess salt and water during not only the intraoperative phase but also the pre- and post-operative ones. For low risk patients, “zero-balance” should be recommended, while for high-risk patients undergoing high-risk surgery, individualized GDT should be considered based on surgical and patient risk factors. Without other problems, detrimental postoperative fluid overload would not be justified and “permissive oliguria” could be tolerated.
