Aporte de volumen en el perioperatorio: ¿Debemos modificar nuestro enfoque?

Resumen

Background: During the perioperative period an adequate intravascular volume must be maintained. Current recommendations overestimate perioperative volume requirements. Aim: To compare perioperative volume administration using standard monitoring methods or guided by left ventricular filling parameters.  Material and methods: Twenty-four patients subjected to colon resection were randomized to monitoring by electrocardiography, blood and central venous pressure, or by transesophageal echocardiography.  In the latter, volume administration was adjusted to maintain basal values of left ventricular end diastolic volume and cardiac index. Results: Patients with the standard monitoring system and transesophageal echocardiographic monitoring received 21.1±12 and 6.3±2 ml/kg/h of fluids during the perioperative period, respectively (p<0.01). Conclusions: The use of transesophageal echocardiography significantly reduced the perioperative fluid administration.