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Multiple studies have demonstrated the favourable outcome achieved by goal-directed fluid management during the intraoperative period. Maximizing stroke volume by optimal fluid loading during high-risk surgery decreases both the incidence of postoperative complications and length of stay in intensive care. 1 Haemodynamic monitoring is essential if fluid therapy is to be accurately titrated. It is crucial that optimal volaemic status is achieved, thus preventing the deleterious effects of inadequate tissue blood flow and also the harmful effects of fluid overload. Administration of excess fluid can cause several problems including an increase in demand in cardiac function as a result of extreme shift of the right on the Starling myocardial performance curve. Fluid accumulation in the lungs predisposes to pneumonia and respiratory failure, while other sequelae include inhibition of gastric motility and poor wound healing. |
