OBJECTIVE The perioperative period is a particularly dangerous time for babies with serious obstetrical brachial plexus injuries undergoing microsurgical reconstruction. The aim of this study was to evaluate the perioperative and early postoperative problems in these patients. METHODS Anesthetic management and pre and postoperative medical records were retrospectively reviewed for infants who...

Although most aspects of perioperative fluid management have remained relatively constant for more than two decades, new concepts and practices are currently evolving. Until the mid-to-late 1960s, the prevailing strategy of perioperative fluid management was rigid restriction (1). After Shires et al. (2,3) convincingly demonstrated that major surgery and trauma were associated with fluid requir...

BACKGROUND Evidence-based guidelines on optimal perioperative fluid management have not been established, and recent randomized trials in major abdominal surgery suggest that large amounts of fluid may increase morbidity and hospital stay. However, no information is available on detailed functional outcomes or with fast-track surgery. Therefore, we investigated the effects of two regimens of in...

BACKGROUND Preoperative fasting may lead to a fluid deficit of about 1 litre, which may contribute to perioperative discomfort and morbidity. We therefore examined the association between perioperatively administered fluids aiming to correct dehydration and clinical outcome. METHODS Review of randomized, controlled, clinical trials evaluating clinical outcome, in which fluid versus no fluid w...

BACKGROUND Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery at the right time and in the right amounts is of great importance. This review aims to analyze the literature concerning perioperative fluid therapy in abdominal surgery and to ...

It has been more than 50 yr since the landmark article in which Holliday and Segar (Pediatrics 1957;19:823-32) proposed the rate and composition of parenteral maintenance fluids for hospitalized children. Much of our practice of fluid administration in the perioperative period is based on this article. The glucose, electrolyte, and intravascular volume requirements of the pediatric surgical pat...

BACKGROUND Recent studies have emphasized the importance of perioperative fluid restriction. However, fluid restriction regimens may increase the likelihood of insufficient perioperative fluid administration or may result in excess intravascular crystalloid replacement. We postulate that the use of transesophageal echocardiography may reduce the amount of crystalloid administered during open an...

Appropriate use of fluid infusion in cardiac surgery patients is of primary importance in the perioperative period in order to optimize cardiac output and oxygen delivery and to reduce the use of vaspressors and inotropes. Fluid infusion is usually triggered by arterial hypotension, low urine output and signs of inadequate tissue oxygenation (e.g. hyperlactatemia). This general rule, however, m...