Fluid Management in Thoracic Surgery

Abstract

Lung injury after thoracic surgery is a major source of postoperative morbidity and mortality. There appears to be a link between excessive perioperative intravenous fluid administration and increased risk for lung injury in thoracic surgical patients for all types of intrathoracic procedures. Thus, a rational approach to perioperative fluid management is crucial to mitigate the risk of postoperative pulmonary injury. While a “restrictive” fluid management approach has long been advocated, there is a paucity of data related to this approach in thoracic surgical patients specifically. Several concepts regarding fluid management can be adapted from the non-cardiothoracic surgery literature, but ultimately more research will be required to define the optimal approach to perioperative fluid management in thoracic surgery.