Restricted or liberal fluid therapy

Abstract

While extreme fluid deprivation and fluid overdose resulting from negligence or misinformed prescription are undoubtedly harmful, observations and experiments do not point to fluid therapy as a significant determinant of patient outcomes from major surgery. Therapy maintaining fluid balance less than 2 l is probably optimal. There are two interdependent fluid circulations (blood and interstitial fluid) serving the needs of cells and intracellular fluid. Filtration rate (Jv) of fluid from the blood circulation to the interstitial circulation is a major determinant of the dynamic equilibrium between plasma volume and interstitial volume. It is affected by anesthesia and by vasoactive agents.