Formal expert recommendations
Guidelines for perioperative haemodynamic optimizationStratégie du remplissage vasculaire périopératoire

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ORGANIZING COMMITTEE

Benoît Vallet, Yvonnick Blanloeil, Bernard Cholley, Gilles Orliaguet, Sébastien Pierre and Benoit Tavernier

WORKING GROUPS

Which monitoring tool to guide fluid management in the operating room?

Olivier Collange, Olivier Desebbe, Jacques Duranteau, Ivan Philip, Benoît Vallet

Which strategy for minor surgery?

Karim Asehnoune, Mathieu Biais, Benoît Tavernier

Which strategy for major surgery?

Jean-Luc Fellahi, Dan Longrois, Gilles Lebuffe, Emmanuel Futier, Bernard Cholley

What are the specific contexts/backgrounds to bear in mind?

Pascale Dewachter, Anne Godier, Olivier Joannes-Boyau, Frederic.J. Mercier, Alexandre Mignon,

SUMMARY

The objective of these recommendations is to review perioperative fluid management (FM) practices, which demonstrated benefits for patients, in order to transfer them to daily practice. In surgical patients considered at “high risk”, it is recommended to titrate the intraoperative FM by measuring stroke volume (SV), in order to reduce postoperative morbidity, hospital stay, and recovery time of oral feeding for patients undergoing digestive surgery. It is recommended to regularly reassess SV

SIMPLIFIED SUMMARY

The administration of fluid through the veins during surgery can change the postoperative outcome of the patient, that is to say the length of hospital stay, and recovery time of oral feeding when the patient undergoes digestive surgery.

In a so-called “high-risk” surgery, it is recommended to guide fluid administration by following the response of the patient's heart through continuous measurement. During “minor” surgery, the continuous measurement is not necessary, but sufficient volume,

Current knowledge

The administration of intravenous fluids, commonly referred to as “fluid management” (FM), is a daily therapeutic practice in the perioperative setting. The fact that this treatment is regularly indispensable for all patients undergoing a surgical procedure is not disputed by anyone. However, the realization of FM needs to be defined, not only through the nature and quantity of fluids to administer, but also through the ways to achieve it.

Physiologically, FM consists in increasing the

Question

Does fluid management guided by Stroke Volume measurement reduce postoperative morbidity and length of stay?

Recommendations and rationale

  • In surgical patients considered at “high risk”, it is recommended to titrate intraoperative volume administration by measuring stroke volume (SV) in order to reduce postoperative morbidity, length of hospital stay and the recovery time of oral feeding for patients undergoing digestive surgery. GRADE 1 +.

Patients at “high risk” means patients who, because of their history or the nature of

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    Approved by the Board of SFAR, 19 October 2012. In collaboration with Adarpef.

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