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LETTERS TO EDITOR
Year : 2018  |  Volume : 12  |  Issue : 4  |  Page : 657-658

Comments on the article “Intraoperative fluid management: Past and future, where is the evidence?”


1 Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Anesthesia, Government Medical College, Jammu, India

Correspondence Address:
Dr. Summit D Bloria
House Number 326, Sector C, Sainik Colony, Jammu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.SJA_385_18

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Date of Web Publication4-Oct-2018
 


How to cite this article:
Bloria SD, Bloria P. Comments on the article “Intraoperative fluid management: Past and future, where is the evidence?”. Saudi J Anaesth 2018;12:657-8

How to cite this URL:
Bloria SD, Bloria P. Comments on the article “Intraoperative fluid management: Past and future, where is the evidence?”. Saudi J Anaesth [serial online] 2018 [cited 2018 Dec 12];12:657-8. Available from: http://www.saudija.org/text.asp?2018/12/4/657/242662



The article by Al-Ghamdi et al. made interesting reading.[1] We would like to highlight the following dynamic parameters that have been used to guide goal-directed fluid therapy (GDFT) in addition to the valuable information provided by the authors:

  1. When using esophageal Doppler for GDFT, corrected flow time has been used as a parameter alongside stroke volume variation to guide intraoperative fluid by many authors.[2],[3],[4] It indicates preload and a value of 330–360 ms is usually considered as normal
  2. Transesophageal echo has been used to guide GDFT. Of the various parameters used are velocity time integral (VTI) variation, superior vena cava variation, inferior vena cava size, variation and left ventricle size, etc. A VTI variation of more than 12% implies fluid responsiveness
  3. Oxygen extraction has also been used to guide intraoperative fluid therapy and has been found to reduce hospital stay and morbidity [5]
  4. Even central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for GDFT intraoperatively.[6]


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  References Top

1.
Al-Ghamdi AA. Intraoperative fluid management: Past and future, where is the evidence?. Saudi J Anaesth 2018;12:311-7.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Sinclair S, James S, Singer M. Intraoperative intravascular volume optimization and length of hospital stay after repair of proximal femoral fracture: Randomized controlled trial. BMJ 1997;315:909-12.  Back to cited text no. 2
    
3.
Conway DH, Mayall R, Abdul-Latif MS, Gilligan S, Tackaberry C. Randomised controlled trial investigating the influence of intravenous fluid titration using oesophageal Doppler monitoring during bowel surgery. Anaesthesia 2002;57:845-9.  Back to cited text no. 3
    
4.
Gan TJ, Soppitt A, Maroof M, El Moalem H, Robertson KM, Moretti E, et al. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology 2002;97:820-6.  Back to cited text no. 4
    
5.
Donati A, Loggi S, Preiser JC, Orsetti G, Münch C, Gabbanelli V, et al. Goal-directed intraoperative therapy reduces morbidity and length of hospital stay in high-risk surgical patients. Chest 2007;132:1817-24.  Back to cited text no. 5
    
6.
Futier E, Robin E, Jabaudon M, Guerin R, Petit A, Bazin JE, et al. Central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery. Crit Care 2010;14:R193.1  Back to cited text no. 6
    




 

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