Complexity of blood volume control system and its implications in perioperative fluid management.

Journal of Anesthesia
Takehiko Iijima

Abstract

The use of fluid therapy attempts to optimize blood circulation by manipulating the circulating blood volume (BV). BV may be a key intermediate parameter between fluid therapy and the blood circulation, and it has been assumed that BV can be controlled by fluid therapy. In order to construct a fluid therapy protocol, firstly, we have to confirm whether BV can actually be controlled by fluid therapy. Volume kinetics studies and dilution techniques for BV measurements have enabled the actual effects of fluid management on BV to be analyzed in the presence of various pathological conditions. Various studies have shown that the effect of fluid, especially crystalloid, on BV varies considerably among individuals, and even BV values measured at a single time point vary from 40 ml kg(-1) to 110 ml kg(-1). It has become apparent that such wide variations in interindividual BV preclude the establishment of universal optimal fluid management protocols. Thus, secondly, it should be clarified how BV is controlled, and whether or not we can control it. Perioperative BV reportedly changes in a manner that is independent of the in-out fluid balance, but is related to hormonal factors. Because inflammation and some hormones control vascular pe...Continue Reading

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Citations

May 23, 2013·Obesity Surgery·Tomi PösöOla Winsö
Jul 16, 2014·PloS One·Matthias DehmerYongtang Shi
May 7, 2013·Journal of the American Animal Hospital Association·Harold DavisUNKNOWN American Animal Hospital Association

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