Kocatepe Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon AD, AFYONKARAHİSAR

Starting from the first administration of intravenous fluid in 1831, perioperative fluid therapy has been one of the most controversial topics in perioperative management untill now. Experience about the effects of different fluids has increased in recent years, and the choice of fluid type in a variety of clinical situations can now be rationally guided by understanding the physicochemical and biological properties of the various crystalloid and colloid solutions available. However, fluid types and strategies of fluid administration, and their relationship to clinical outcomes are not clear today. Life-threatening consequences of inadequate fluid therapy are lactic acidosis, acute renal failure and multisystem organ failure. Life-threatening consequences of excessive fluid therapy are pulmonary edema and cardiac failure. Nonfatal consequences of excessive fluid therapy are peripheral edema, periorbital edema, impaired gut function and impaired wound healing. Crystalloid fluids poorly expand the intravascular volume and the effect rapidly resolves. Colloids more effectively expand blood volume. In conscious volunteers, most of the unretained fluid is renally excreted, eventually. Larger volumes may remain for considerable intervals. We can’t accurately evaluate blood volume, identify fluid overload, identify hypovolemia, and evaluate tissue perfusionin at the present. But we know that certainly enough fluid should be given, too much is clearly bad, and colloid solutions may improve outcome beter than crystalloids.