Perioperative Goal-Directed Fluid Therapy: A Prime Component of Enhanced Recovery After Surgery.

Nina McLain, Stephanie Parks, Mary Jane Collins

Journal: AANA journal 2021;89(4):351-357

PMID: 34342573

Abstract

Perioperative goal-directed fluid therapy (GDFT) is a prime component of the Enhanced Recovery After Surgery (ERAS) protocol. Multiple studies have demonstrated a relationship between GDFT and positive patient outcomes, including shorter hospital stays, decreased ileus formation, reduced gastrointestinal-related issues, decreased nausea, and hemodynamic stability. Electrolyte disturbances following a positive fluid balance may occur, and GDFT is aimed at euvolemia to avoid a hypervolemic state. Carbohydrate loading, early discontinuation of postoperative intravenous fluids, and use of isoosmotic solutions all are components of GDFT. Lactated Ringer's solution is the fluid recommended for nonrenal patients and patients with hepatic compromise. The negative consequences associated with hypervolemia deem it pertinent to devise an individualized GDFT plan in the ERAS protocol.

Address: earned her PhD from Virginia Commonwealth University in Richmond, Virginia, in 2007. She has served as faculty at Samford University in Homewood, Alabama, and is currently the Nurse Anesthesia Program administrator at The University of Southern Mississippi (USM) in Hattiesburg, Mississippi.; received her doctorate from USM in 2015. She served as faculty at Franciscan University in Baton Rouge, Louisiana, and is currently a professor at USM in the Nurse Anesthesia Program.; received her doctorate in healthcare administration from the University of Mississippi Medical Center in Jackson, Mississippi, where she also completed a yearlong fellowship in health policy with the Mississippi legislature. She currently serves as the assistant program administrator at USM.

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Free resources

Medical:

https://medlineplus.gov/aftersurgery.html

MeSH Terms: Adult, Anesthesiology, Curriculum, Education, Nursing, Continuing, Enhanced Recovery After Surgery, Female, Fluid Therapy, Humans, Male, Middle Aged, Nurse Anesthetists, Perioperative Care, Postoperative Complications, Practice Guidelines as Topic