• Best Pract Res Clin Anaesthesiol · Sep 2017

    Review

    Impact of volume status and volume therapy on the kidney.

    • David A Roberts and Andrew D Shaw.
    • Vanderbilt University Medical Center, 1211 Medical Center Drive, 2301 VUH C/o Robin Snyder, USA; Department of Anesthesiology, Vanderbilt University Medical Center, USA. Electronic address: david.alan.roberts@vanderbilt.edu.
    • Best Pract Res Clin Anaesthesiol. 2017 Sep 1; 31 (3): 345-352.

    AbstractVolume resuscitation to correct hypotension in surgical and critically ill patients is a common practice. Available evidence suggests that iatrogenic volume overload is associated with worse outcomes in established acute kidney injury. Intraoperative arterial hypotension is associated with postoperative renal dysfunction, and prompt correction with fluid management protocols that combine inotrope infusions with volume therapy targeted to indices of volume responsiveness should be considered. From the perspective of renal function, the minimum amount of intravenous fluid required to maintain perfusion and oxygen delivery is desirable. Available evidence and expert opinion suggest that balanced crystalloid solutions are preferable to isotonic saline for volume resuscitation. Moreover, albumin has a similar safety profile as crystalloids. Hetastarch-containing colloids have a clear association with acute kidney injury.Copyright © 2017 Elsevier Ltd. All rights reserved.

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