American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative  (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery

• Published in: Perioperative medicine (London) Vol. 5; no. 1; p. 24
• Main Authors: Thiele, Robert H, Raghunathan, Karthik, Brudney, C S, Lobo, Dileep N, Martin, Daniel, Senagore, Anthony, Cannesson, Maxime, Gan, Tong Joo, Mythen, Michael Monty G, Shaw, Andrew D, Miller, Timothy E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17-09-2016; BioMed Central; BMC
• Subjects: Advisors; Colloids; Colorectal surgery; Consensus Statement; Crystalloids; Decision making; Enhanced recovery; Enhanced recovery pathway; Evaluation; Fluid; Fluid therapy; Fluids; Hydration; Life sciences; Methods; Monitoring systems; Patient outcomes; Patient satisfaction; Patients; Perioperative care; Physiological aspects; Practice guidelines (Medicine); Recovery of function; Research funding; Society; Surgical outcomes; United States; Fluids; Goal-directed fluid therapy; Colloids; Enhanced recovery pathway; Enhanced recovery; Carbohydrate drink; Hemodynamics; Colorectal surgery; Crystalloids
• ISSN: 2047-0525; 2047-0525
• DOI: 10.1186/s13741-016-0049-9

Enhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There is some controversy about the adoption of specific elements in enhanced recovery "bundles" because the relative importance of different components of ERPs is hard to discern (a consequence of multiple simultaneous changes in clinical practice when ERPs are initiated). There is evidence that specific approaches to fluid management are better than alternatives in patients undergoing colorectal surgery; however, several specific questions remain.
In the "Perioperative Quality Initiative (POQI) Fluids" workgroup, we developed a framework broadly applicable to the perioperative management of intravenous fluid therapy in patients undergoing elective colorectal surgery within an ERP.
We discussed aspects of ERPs that impact fluid management and made recommendations or suggestions on topics such as bowel preparation; preoperative oral hydration; intraoperative fluid therapy with and without devices for goal-directed fluid therapy; and type of fluid.