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Post-operative fluid and circulatory management in the ICU 

Post-operative fluid and circulatory management in the ICU
Chapter:
Post-operative fluid and circulatory management in the ICU
Author(s):

Claudia Ebm

and Andrew Rhodes

DOI:
10.1093/med/9780199600830.003.0363
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date: 01 August 2021

Fluid and circulatory management is an integral part of the peri-operative care of critically-ill patients. Precisely estimating the volumetric needs of post-operative patients remains difficult. While the majority of patients tolerate intra-operative fluid loss easily, patients with reduced physiological reserve present more of a challenge. Targeting specific physiological goals and optimizing haemodynamics with fluids and inotropes, means outcomes of these patients can be improved. This approach is often referred as goal-directed therapy (GDT). ‘Individualized goal-directed therapy’ can vary in timing, monitoring techniques, and endpoints used. The emergence of minimal invasive devises has allowed us to integrate cardiac output monitoring as a safe and reliable tool in the routine care of high risk patients. This dynamic assessment of haemodynamics provides a reliable technique to assess volume responsiveness and guide fluids to optimize cardiac output and oxygen delivery.

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