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What happened in the meantime? (results recent trials) – Robert Hahn
4:15 PM - 4:30 PM
Fri Nov 23, 2018
Grote Zaal

Description

Learning objectives:

  1. There are more than 100 studies of perioperative goal-directed fluid therapy, but potential benefits are currently blurred by heterogeneity. New large studies are ongoing.
  2. The RELIEF study from Australia suggests that liberal fluid therapy reduces the incidence of postoperative kidney injury.
  3. The intravascular persistence time of 20% albumin is several times longer than when the same amount of albumin is infused as a 5% solution.

Take home messages:

  1. More studies of goal-directed fluid therapy are underway. Still, differences between the many smaller studies make the technique difficult to evaluate.
  2. The differences messages given by "big data" studies and physiology-oriented studies deserve more critical debate.
  3. 20% albumin is probably a "slow-release" preparation that expands the plasma volume for more than one whole day.

References

  1. Kaufmann T, Clement RP, Scheeren TWL, Saugel B, Keus F, van der Horst ICC. Perioperative goal-directed therapy: A systematic review without meta-analysis. Acta Anaesthesiol Scand 2018; 62: 1340-1355.
  2. Myles PS et al. Restrictive versus liberal fluid therapy for major abdominal surgery. NEJM 2018; 378: 2262-2274.

 


Speaker
 
Robert Hahn
Research Director, Professor of anaesthesia and intensive care, Södertälje Hospital and Karolinska Institutet at Danderyds Hospital (KIDS), Stockholm, Sweden

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