Should fluid management in thoracic surgery be goal directed?

Senturk M., Bingul E. S., Turhan O.

CURRENT OPINION IN ANESTHESIOLOGY, vol.35, no.1, pp.89-95, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 35 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.1097/aco.0000000000001083
  • Journal Name: CURRENT OPINION IN ANESTHESIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.89-95
  • Keywords: fluid management, Goal-Directed Therapy, thoracic anesthesia, ACUTE KIDNEY INJURY, POSTOPERATIVE PULMONARY COMPLICATIONS, ASSISTED THORACOSCOPIC SURGERY, STROKE VOLUME VARIATION, ONE-LUNG VENTILATION, HEMODYNAMIC THERAPY, RESECTION, OUTCOMES, RESPONSIVENESS, ESOPHAGECTOMY
  • Istanbul University Affiliated: Yes

Abstract

Purpose of review To find a reliable answer to the question in the title: Should fluid management in thoracic surgery be goal directed? Recent findings 'Moderate' fluid regimen is the current recommendation of fluid management in thoracic anesthesia, however, especially in more risky patients; 'Goal-Directed Therapy' (GDT) can be a more reliable approach than just 'moderate'. There are numerous studies examining its effects in general anesthesia; albeit mostly retrospective and very heterogenic. There are few studies of GDT in thoracic anesthesia with similar drawbacks. Although the evidence level is low, GDT is generally associated with fewer postoperative complications. It can be helpful in decision-making for volume-optimization, timing of fluid administration, and indication of vasoactive agents.