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Fluidoterapia perioperatória : o estado da arte
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Resumo(s)
A hipovolémia perioperatória e o excesso de fluidos têm consequências nas complicações pós-operatórias e na sobrevida do paciente. Assim, a administração de fluidos antes, durante e após a cirurgia, no tempo certo e com o volume adequado é de grande importância. A fluidoterapia perioperatória continua a ser um tema muito debatido e, apesar de se saber que tanto o excesso como a falta de fluidos podem trazer consequência nefastas, continua a existir uma grande variabilidade na prática clínica da administração de fluidos. Este artigo de revisão tem como objetivo analisar a literatura referente à fluidoterapia perioperatória com o intuito de compreender a fisiologia dos fluidos e do endotélio vascular, definir os riscos e os benefícios associados à escolha de cada tipo de fluido, perceber quando estes devem ser administrados e finalmente tirar conclusões que permitam reduzir a variabilidade de aplicação da técnica anestésica na temática da fluidoterapia. Para a construção deste artigo foram analisados 158 artigos sobre fluidoterapia incluindo artigos baseados na população cirúrgica e dos cuidados intensivos.
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. Perioperative fluid therapy remains a highly-debated topic and even though it is known that over and under-hydration is bad there is wide variability of practice between individuals. This review article aims to analyze the literature concerning perioperative fluid therapy with the objective of understanding the fluids and endothelial layer physiology, to clearly define the risks and benefits of fluids choices, to know when to administer fluids and ultimately to reduce the variability with which perioperative fluids are administered. For this article, it was reviewed data from 158 fluid therapy articles including both operative and intensive care unit population.
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. Perioperative fluid therapy remains a highly-debated topic and even though it is known that over and under-hydration is bad there is wide variability of practice between individuals. This review article aims to analyze the literature concerning perioperative fluid therapy with the objective of understanding the fluids and endothelial layer physiology, to clearly define the risks and benefits of fluids choices, to know when to administer fluids and ultimately to reduce the variability with which perioperative fluids are administered. For this article, it was reviewed data from 158 fluid therapy articles including both operative and intensive care unit population.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Fluidoterapia perioperatória Colóides Cristalóides Indices dinâmicos Anestesiologia