The pathophysiology of fluid and electrolyte balance in the older adult surgical patient

Clinical Nutrition

Volumn 33, Issue 1, 2014, Pages 6-13

  El Sharkawy, Ahmed M ^a   Sahota, Opinder ^a   Maughan, Ron J ^b   Lobo, Dileep N ^a  

^a QUEEN S MEDICAL CENTRE   (United Kingdom)

^b LOUGHBOROUGH UNIVERSITY   (United Kingdom)

Author keywords

Clinical outcome; Dehydration; Fluid and electrolytes; Fluid overload; Older adults; Pathophysiology

Indexed keywords

AGED; AGING; COGNITIVE DEFECT; DEHYDRATION; DISEASE ASSOCIATION; DISEASE EXACERBATION; DISEASE PREDISPOSITION; DYSNATREMIA; ELECTROLYTE BALANCE; ELECTROLYTE DISTURBANCE; FLUID BALANCE; FLUID INTAKE; FLUID RETENTION; FLUID THERAPY; HORMONAL REGULATION; HUMAN; IATROGENIC DISEASE; KIDNEY FUNCTION; MORBIDITY; MORTALITY; PATHOPHYSIOLOGY; PERIOPERATIVE PERIOD; PHYSICAL DISABILITY; REVIEW; RISK FACTOR; SENESCENCE; SURGICAL PATIENT; THIRST;

CLINICAL OUTCOME; DEHYDRATION; FLUID AND ELECTROLYTES; FLUID OVERLOAD; OLDER ADULTS; PATHOPHYSIOLOGY;

ACUTE KIDNEY INJURY; AGED; AGING; COGNITION DISORDERS; CRITICAL ILLNESS; DEHYDRATION; FLUID THERAPY; HUMANS; KIDNEY; PERIOPERATIVE PERIOD; RISK FACTORS; THIRST; WATER-ELECTROLYTE BALANCE;

EID: 84892551320     PISSN: 02615614     EISSN: 15321983     Source Type: Journal    
DOI: 10.1016/j.clnu.2013.11.010     Document Type: Review

References (119)

1. The Information Centre for Health and Social Care. 2012 [accessed 22.05.12 at 14:00]. http://www.ic.nhs.uk/news-and-events/news/elderly-people-account-for-bigger-proportion-of-nhs-hospital-activity-every-year-report-shows.
2. Cracknell R. The ageing population. [accessed 14.08.12 at 09:00]. http://www.parliament.uk/business/publications/research/key-issues-for-the-new-parliament/value-for-money-in-public-services/the-ageing-population/.
3. Allison S.P., Lobo D.N. Fluid and electrolytes in the elderly. Curr Opin Clin Nutr Metab Care 2004, 7:27-33.
4. Gaspar P.M. Water intake of nursing home residents. JGerontol Nurs 1999, 25:23-29.
5. Foroni M., Salvioli G., Rielli R., Goldoni C.A., Orlandi G., Zauli Sajani S., et al. Aretrospective study on heat-related mortality in an elderly population during the 2003 heat wave in Modena, Italy: the Argento Project. JGerontol A Biol Sci Med Sci 2007, 62:647-651.
6. Hari M., Rosenzweig M. Incidence of preventable postoperative readmissions following pancreaticoduodenectomy: implications for patient education. Oncol Nurs Forum 2012, 39:408-412.
7. Khan M.A., Hossain F.S., Dashti Z., Muthukumar N. Causes and predictors of early re-admission after surgery for a fracture of the hip. JBone Joint Surg Br 2012, 94:690-697.
8. Messaris E., Sehgal R., Deiling S., Koltun W.A., Stewart D., McKenna K., et al. Dehydration is the most common indication for readmission after diverting ileostomy creation. Dis Colon Rectum 2012, 55:175-180.
9. Grandjean A.C., Grandjean N.R. Dehydration and cognitive performance. JAm Coll Nutr 2007, 26:549S-554S.
10. Warren J.L., Bacon W.E., Harris T., McBean A.M., Foley D.J., Phillips C. The burden and outcomes associated with dehydration among US elderly, 1991. Am J Public Health 1994, 84:1265-1269.
11. Desborough J.P. The stress response to trauma and surgery. Br J Anaesth 2000, 85:109-117.
12. Bagshaw S.M., Brophy P.D., Cruz D., Ronco C. Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury. Crit Care 2008, 12:169.
13. Payen D., de Pont A.C., Sakr Y., Spies C., Reinhart K., Vincent J.L. Apositive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 2008, 12:R74.
14. Lindeman R.D., Tobin J., Shock N.W. Longitudinal studies on the rate of decline in renal function with age. JAm Geriatr Soc 1985, 33:278-285.
15. Schlanger L.E., Bailey J.L., Sands J.M. Electrolytes in the aging. Adv Chronic Kidney Dis 2010, 17:308-319.
16. Melk A. Senescence of renal cells: molecular basis and clinical implications. Nephrol Dial Transplant 2003, 18:2474-2478.
17. Kenney W.L., Chiu P. Influence of age on thirst and fluid intake. Med Sci Sports Exerc 2001, 33:1524-1532.
18. Phillips P.A., Bretherton M., Risvanis J., Casley D., Johnston C., Gray L. Effects of drinking on thirst and vasopressin in dehydrated elderly men. Am J Physiol 1993, 264:R877-R881.
19. Phillips P.A., Johnston C.I., Gray L. Disturbed fluid and electrolyte homoeostasis following dehydration in elderly people. Age Ageing 1993, 22:S26-S33.
20. Leiper J.B., Seonaid Primrose C., Primrose W.R., Phillimore J., Maughan R.J. Acomparison of water turnover in older people in community and institutional settings. JNutr Health Aging 2005, 9:189-193.
21. Berardesca E., Maibach H.I. Transepidermal water loss and skin surface hydration in the non invasive assessment of stratum corneum function. Derm Beruf Umwelt 1990, 38:50-53.
22. Wilhelm K.P., Cua A.B., Maibach H.I. Skin aging. Effect on transepidermal water loss, stratum corneum hydration, skin surface pH, and casual sebum content. Arch Dermatol 1991, 127:1806-1809.
23. Flynn A., McGreevy C., Mulkerrin E.C. Why do older patients die in a heatwave?. QJM 2005, 98:227-229.
24. Nyengaard J.R., Bendtsen T.F. Glomerular number and size in relation to age, kidney weight, and body surface in normal man. Anat Rec 1992, 232:194-201.
25. Epstein M. Aging and the kidney. JAm Soc Nephrol 1996, 7:1106-1122.
26. Hawkins R.C. Age and gender as risk factors for hyponatremia and hypernatremia. Clin Chim Acta 2003, 337:169-172.
27. Musso C., Liakopoulos V., De Miguel R., Imperiali N., Algranati L. Transtubular potassium concentration gradient: comparison between healthy old people and chronic renal failure patients. Int Urol Nephrol 2006, 38:387-390.
28. Frassetto L., Sebastian A. Age and systemic acid-base equilibrium: analysis of published data. JGerontol A Biol Sci Med Sci 1996, 51:B91-B99.
29. Berkemeyer S., Vormann J., Gunther A.L., Rylander R., Frassetto L.A., Remer T. Renal net acid excretion capacity is comparable in prepubescence, adolescence, and young adulthood but falls with aging. JAm Geriatr Soc 2008, 56:1442-1448.
30. Messerli F.H., Sundgaard-Riise K., Ventura H.O., Dunn F.G., Glade L.B., Frohlich E.D. Essential hypertension in the elderly: haemodynamics, intravascular volume, plasma renin activity, and circulating catecholamine levels. Lancet 1983, 2:983-986.
31. Hollenberg N.K., Adams D.F., Solomon H.S., Rashid A., Abrams H.L., Merrill J.P. Senescence and the renal vasculature in normal man. Circ Res 1974, 34:309-316.
32. Beck L.H. The aging kidney. Defending a delicate balance of fluid and electrolytes. Geriatrics 2000, 55:26-28. 31-2.
33. Lobo D.N., Stanga Z., Aloysius M.M., Wicks C., Nunes Q.M., Ingram K.L., et al. Effect of volume loading with 1 liter intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three-way crossover study in healthy volunteers. Crit Care Med 2010, 38:464-470.
34. Kenny R.A., Lyon C.C., Bayliss J., Lightman S.L., Sutton R. Reduced plasma renin activity in elderly subjects in response to vasovagal hypotension and head-up tilt. Age Ageing 1987, 16:171-177.
35. Ohashi M., Fujio N., Nawata H., Kato K., Ibayashi H., Kangawa K., et al. High plasma concentrations of human atrial natriuretic polypeptide in aged men. JClin Endocrinol Metab 1987, 64:81-85.
36. Kurtz A., Della Bruna R., Pfeilschifter J., Taugner R., Bauer C. Atrial natriuretic peptide inhibits renin release from juxtaglomerular cells by a cGMP-mediated process. Proc Natl Acad Sci U S A 1986, 83:4769-4773.
37. Ling B.N., Kemendy A.E., Kokko K.E., Hinton C.F., Marunaka Y., Eaton D.C. Regulation of the amiloride-blockable sodium channel from epithelial tissue. Mol Cell Biochem 1990, 99:141-150.
38. Asplund R., Aberg H. Diurnal variation in the levels of antidiuretic hormone in the elderly. JIntern Med 1991, 229:131-134.
39. Stachenfeld N.S., Mack G.W., Takamata A., DiPietro L., Nadel E.R. Thirst and fluid regulatory responses to hypertonicity in older adults. Am J Physiol 1996, 271:R757-R765.
40. Phillips P.A., Rolls B.J., Ledingham J.G., Forsling M.L., Morton J.J., Crowe M.J., et al. Reduced thirst after water deprivation in healthy elderly men. NEngl J Med 1984, 311:753-759.
41. Albert S.G., Nakra B.R.S., Grossberg G.T., Caminal E.R. Vasopressin response to dehydration in Alzheimers-disease. JAm Geriatr Soc 1989, 37:843-847.
42. McAloon Dyke M., Davis K.M., Clark B.A., Fish L.C., Elahi D., Minaker K.L. Effects of hypertonicity on water intake in the elderly: an age-related failure. Geriatr Nephrol Urol 1997, 7:11-16.
43. Phillips P.A., Bretherton M., Johnston C.I., Gray L. Reduced osmotic thirst in healthy elderly men. Am J Physiol 1991, 261:R166-R171.
44. Phillips P.A., Rolls B.J., Ledingham J.G.G., Forsling M.L., Morton J.J., Crowe M.J., et al. Reduced thirst after water-deprivation in healthy elderly men. NEngl J Med 1984, 311:753-759.
45. Silver A.J., Morley J.E. Role of the opioid system in the hypodipsia associated with aging. JAm Geriatr Soc 1992, 40:556-560.
46. Stachenfeld N.S., DiPietro L., Nadel E.R., Mack G.W. Mechanism of attenuated thirst in aging: role of central volume receptors. Am J Physiol 1997, 272:R148-R157.
47. Mack G.W., Weseman C.A., Langhans G.W., Scherzer H., Gillen C.M., Nadel E.R. Body fluid balance in dehydrated healthy older men: thirst and renal osmoregulation. JAppl Physiol 1994, 76:1615-1623.
48. Burrell L.M., Lambert H.J., Baylis P.H. Effect of atrial natriuretic peptide on thirst and arginine vasopressin release in humans. Am J Physiol 1991, 260:R475-R479.
49. Phillips P.A., Rolls B.J., Ledingham J.G., Morton J.J. Body fluid changes, thirst and drinking in man during free access to water. Physiol Behav 1984, 33:357-363.
50. Alshayeb H.M., Showkat A., Babar F., Mangold T., Wall B.M. Severe hypernatremia correction rate and mortality in hospitalized patients. Am J Med Sci 2011, 341:356-360.
51. Snyder N.A., Feigal D.W., Arieff A.I. Hypernatremia in elderly patients. A heterogeneous, morbid, and iatrogenic entity. Ann Intern Med 1987, 107:309-319.
52. Herrod P.J., Awad S., Redfern A., Morgan L., Lobo D.N. Hypo- and hypernatraemia in surgical patients: is there room for improvement?. World J Surg 2010, 34:495-499.
53. Gankam Kengne F., Andres C., Sattar L., Melot C., Decaux G. Mild hyponatremia and risk of fracture in the ambulatory elderly. QJM 2008, 101:583-588.
54. Zilberberg M.D., Exuzides A., Spalding J., Foreman A., Jones A.G., Colby C., et al. Epidemiology, clinical and economic outcomes of admission hyponatremia among hospitalized patients. Curr Med Res Opin 2008, 24:1601-1608.
55. Kinsella S., Moran S., Sullivan M.O., Molloy M.G., Eustace J.A. Hyponatremia independent of osteoporosis is associated with fracture occurrence. Clin J Am Soc Nephrol 2010, 5:275-280.
56. Barsony J., Manigrasso M., Tam H., Xu Q., Sugimura Y., Tian Y., et al. Hyponatremia-induced osteoporosis. Osteoporos Int 2009, 20. S216-S16.
57. Waikar S.S., Mount D.B., Curhan G.C. Mortality after hospitalization with mild, moderate, and severe hyponatremia. Am J Med 2009, 122:857-865.
58. Anderson R.J., Chung H.M., Kluge R., Schrier R.W. Hyponatremia: a prospective analysis of its epidemiology and the pathogenetic role of vasopressin. Ann Intern Med 1985, 102:164-168.
59. Chowdhury A.H., Cox E.F., Francis S.T., Lobo D.N. Arandomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and Plasma-Lyte(R) 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers. Ann Surg 2012, 256:18-24.
60. Biswas K., Mulkerrin E.C. Potassium homoeostasis in the elderly. QJM 1997, 90:487-492.
61. Mulkerrin E., Epstein F.H., Clark B.A. Aldosterone responses to hyperkalemia in healthy elderly humans. JAm Soc Nephrol 1995, 6:1459-1462.
62. Clark B.A., Brown R.S., Epstein F.H. Effect of atrial natriuretic peptide on potassium-stimulated aldosterone secretion: potential relevance to hypoaldosteronism in man. JClin Endocrinol Metab 1992, 75:399-403.
63. Gullestad L., Nes M., Ronneberg R., Midtvedt K., Falch D., Kjekshus J. Magnesium status in healthy free-living elderly Norwegians. JAm Coll Nutr 1994, 13:45-50.
64. Rude R.K. Magnesium deficiency: a cause of heterogeneous disease in humans. JBone Miner Res 1998, 13:749-758.
65. Rylander R., Remer T., Berkemeyer S., Vormann J. Acid-base status affects renal magnesium losses in healthy, elderly persons. JNutr 2006, 136:2374-2377.
66. Safavi M., Honarmand A. Admission hypomagnesemia-impact on mortality or morbidity in critically ill patients. Middle East J Anesthesiol 2007, 19:645-660.
67. Cuddy M.L. The effects of drugs on thermoregulation. AACN Clin Issues 2004, 15:238-253.
68. Nadler J.L., Lee F.O., Hsueh W., Horton R. Evidence of prostacyclin deficiency in the syndrome of hyporeninemic hypoaldosteronism. NEngl J Med 1986, 314:1015-1020.
69. Gurwitz J.H., Field T.S., Harrold L.R., Rothschild J., Debellis K., Seger A.C., et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA 2003, 289:1107-1116.
70. Chapman M.D., Hanrahan R., McEwen J., Marley J.E. Hyponatraemia and hypokalaemia due to indapamide. Med J Aust 2002, 176:219-221.
71. Sandhofer A., Kahler C., Heininger D., Bellmann R., Wiedermann C.J., Joannidis M. Severe electrolyte disturbances and renal failure in elderly patients with combined diuretic therapy including xipamid. Wien Klin Wochenschr 2002, 114:938-942.
72. Wierenga P.C., Buurman B.M., Parlevliet J.L., van Munster B.C., Smorenburg S.M., Inouye S.K., et al. Association between acute geriatric syndromes and medication-related hospital admissions. Drugs Aging 2012, 29:691-699.
73. Klopotowska J.E., Wierenga P.C., Smorenburg S.M., Stuijt C.C., Arisz L., Kuks P.F., et al. Recognition of adverse drug events in older hospitalized medical patients. Eur J Clin Pharmacol 2013, 69:75-85.
74. Thomsen L.A., Winterstein A.G., Sondergaard B., Haugbolle L.S., Melander A. Systematic review of the incidence and characteristics of preventable adverse drug events in ambulatory care. Ann Pharmacother 2007, 41:1411-1426.
75. Schols J.M., De Groot C.P., van der Cammen T.J., Olde Rikkert M.G. Preventing and treating dehydration in the elderly during periods of illness and warm weather. JNutr Health Aging 2009, 13:150-157.
76. Fouillet A., Rey G., Laurent F., Pavillon G., Bellec S., Guihenneuc-Jouyaux C., et al. Excess mortality related to the August 2003 heat wave in France. Int Arch Occup Environ Health 2006, 80:16-24.
77. Olde Rikkert M.G., Deurenberg P., Jansen R.W., van't Hof M.A., Hoefnagels W.H. Validation of multi-frequency bioelectrical impedance analysis in detecting changes in fluid balance of geriatric patients. JAm Geriatr Soc 1997, 45:1345-1351.
78. Mentes J. Oral hydration in older adults: greater awareness is needed in preventing, recognizing, and treating dehydration. Am J Nurs 2006, 106:40-49. quiz 50.
79. Adan A. Cognitive performance and dehydration. JAm Coll Nutr 2012, 31:71-78.
80. Cox P. Insensible water loss and its assessment in adult patients: a review. Acta Anaesthesiol Scand 1987, 31:771-776.
81. Woodrow P. Assessing fluid balance in older people: fluid needs. Nurs Older People 2002, 14:31-32.
82. Shimizu M., Kinoshita K., Hattori K., Ota Y., Kanai T., Kobayashi H., et al. Physical signs of dehydration in the elderly. Intern Med 2012, 51:1207-1210.
83. Arieff A.I. Fatal postoperative pulmonary edema: pathogenesis and literature review. Chest 1999, 115:1371-1377.
84. Lobo D.N., Macafee D.A., Allison S.P. How perioperative fluid balance influences postoperative outcomes. Best Pract Res Clin Anaesthesiol 2006, 20:439-455.
85. Holte K., Sharrock N.E., Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth 2002, 89:622-632.
86. Michell A.R. Diuresis and diarrhea: is the gut a misunderstood nephron?. Perspect Biol Med 2000, 43:399-405.
87. Lobo D.N., Bostock K.A., Neal K.R., Perkins A.C., Rowlands B.J., Allison S.P. Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial. Lancet 2002, 359:1812-1818.
88. Chowdhury A.H., Lobo D.N. Fluids and gastrointestinal function. Curr Opin Clin Nutr Metab Care 2011, 14:469-476.
89. Shandall A., Lowndes R., Young H.L. Colonic anastomotic healing and oxygen tension. Br J Surg 1985, 72:606-609.
90. Wilkes N.J., Woolf R., Mutch M., Mallett S.V., Peachey T., Stephens R., et al. The effects of balanced versus saline-based hetastarch and crystalloid solutions on acid-base and electrolyte status and gastric mucosal perfusion in elderly surgical patients. Anesth Analg 2001, 93:811-816.
91. Schnuriger B., Inaba K., Wu T., Eberle B.M., Belzberg H., Demetriades D. Crystalloids after primary colon resection and anastomosis at initial trauma laparotomy: excessive volumes are associated with anastomotic leakage. JTrauma 2011, 70:603-610.
92. Brandstrup B., Tonnesen H., Beier-Holgersen R., Hjortso E., Ording H., Lindorff-Larsen K., et al. Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial. Ann Surg 2003, 238:641-648.
93. McArdle G.T., McAuley D.F., McKinley A., Blair P., Hoper M., Harkin D.W. Preliminary results of a prospective randomized trial of restrictive versus standard fluid regime in elective open abdominal aortic aneurysm repair. Ann Surg 2009, 250:28-34.
94. Neal J.M., Wilcox R.T., Allen H.W., Low D.E. Near-total esophagectomy: the influence of standardized multimodal management and intraoperative fluid restriction. Reg Anesth Pain Med 2003, 28:328-334.
95. Varadhan K.K., Lobo D.N. Ameta-analysis of randomised controlled trials of intravenous fluid therapy in major elective open abdominal surgery: getting the balance right. Proc Nutr Soc 2010, 69:488-498.
96. Callum K.G., Gray A.J., Hoile R.W., Ingram G.S., Martin I.C., Sherry K.M., et al. Extremes of age: the 1999 report of the national confidential enquiry into perioperative deaths 1999, National Confidential Enquiry into Perioperative Deaths, London.
97. Awad S., Allison S.P., Lobo D.N. The history of 0.9% saline. Clin Nutr 2008, 27:179-188.
98. Reid F., Lobo D.N., Williams R.N., Rowlands B.J., Allison S.P. (Ab)normal saline and physiological Hartmann's solution: a randomized double-blind crossover study. Clin Sci (Lond) 2003, 104:17-24.
99. Williams E.L., Hildebrand K.L., McCormick S.A., Bedel M.J. The effect of intravenous lactated Ringer's solution versus 0.9% sodium chloride solution on serum osmolality in human volunteers. Anesth Analg 1999, 88:999-1003.
100. Drummer C., Gerzer R., Heer M., Molz B., Bie P., Schlossberger M., et al. Effects of an acute saline infusion on fluid and electrolyte metabolism in humans. Am J Physiol 1992, 262:F744-F754.
101. Shaw A.D., Bagshaw S.M., Goldstein S.L., Scherer L.A., Duan M., Schermer C.R., et al. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to plasma-lyte. Ann Surg 2012, 255:821-829.
102. Yunos N.M., Bellomo R., Hegarty C., Story D., Ho L., Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults. JAMA 2012, 308:1566-1572.
103. McCluskey S.A., Karkouti K., Wijeysundera D., Minkovich L., Tait G., Beattie W.S. Hyperchloremia after noncardiac surgery is independently associated with increased morbidity and mortality: a propensity-matched cohort study. Anesth Analg 2013, 117:412-421.
104. Jiang G.Q., Peng M.H., Yang D.H. Effect of perioperative fluid therapy on early phase prognosis after liver transplantation. Hepatobiliary Pancreat Dis Int 2008, 7:367-372.
105. Walsh S.R., Tang T.Y., Farooq N., Coveney E.C., Gaunt M.E. Perioperative fluid restriction reduces complications after major gastrointestinal surgery. Surgery 2008, 143:466-468.
106. Sinclair S., James S., Singer M. Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ 1997, 315:909-912.
107. Venn R., Steele A., Richardson P., Poloniecki J., Grounds M., Newman P. Randomized controlled trial to investigate influence of the fluid challenge on duration of hospital stay and perioperative morbidity in patients with hip fractures. Br J Anaesth 2002, 88:65-71.
108. Abbas S.M., Hill A.G. Systematic review of the literature for the use of oesophageal Doppler monitor for fluid replacement in major abdominal surgery. Anaesthesia 2008, 63:44-51.
109. Noblett S.E., Snowden C.P., Shenton B.K., Horgan A.F. Randomized clinical trial assessing the effect of Doppler-optimized fluid management on outcome after elective colorectal resection. Br J Surg 2006, 93:1069-1076.
110. Conway D.H., Mayall R., Abdul-Latif M.S., Gilligan S., Tackaberry C. Randomised controlled trial investigating the influence of intravenous fluid titration using oesophageal Doppler monitoring during bowel surgery. Anaesthesia 2002, 57:845-849.
111. Gan T.J., Soppitt A., Maroof M., el-Moalem H., Robertson K.M., Moretti E., et al. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology 2002, 97:820-826.
112. Mythen M.G., Webb A.R. Intra-operative gut mucosal hypoperfusion is associated with increased post-operative complications and cost. Intensive Care Med 1994, 20:99-104.
113. Wakeling H.G., McFall M.R., Jenkins C.S., Woods W.G., Miles W.F., Barclay G.R., et al. Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth 2005, 95:634-642.
114. Walsh S.R., Tang T., Bass S., Gaunt M.E. Doppler-guided intra-operative fluid management during major abdominal surgery: systematic review and meta-analysis. Int J Clin Pract 2008, 62:466-470.
115. Brandstrup B., Svendsen P.E., Rasmussen M., Belhage B., Rodt S.A., Hansen B., et al. Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near-maximal stroke volume or zero fluid balance?. Br J Anaesth 2012, 109:191-199.
116. Srinivasa S., Taylor M.H., Singh P.P., Yu T.C., Soop M., Hill A.G. Randomized clinical trial of goal-directed fluid therapy within an enhanced recovery protocol for elective colectomy. Br J Surg 2013, 100:66-74.
117. Stoneham M.D., Hill E.L. Variability in post-operative fluid and electrolyte prescription. Br J Clin Pract 1997, 51:82-84.
118. Lobo D.N., Dube M.G., Neal K.R., Simpson J., Rowlands B.J., Allison S.P. Problems with solutions: drowning in the brine of an inadequate knowledge base. Clin Nutr 2001, 20:125-130.
119. Awad S., Allison S.P., Lobo D.N. Fluid and electrolyte balance: the impact of goal directed teaching. Clin Nutr 2008, 27:473-478.