Anaes Vivas · Perioperative fluid & goal-directed therapy
Perioperative fluid & goal-directed therapy — Viva
Viva on Hahn kinetics, Michard responsiveness limits, OPTIMISE/RELIEF trial-exact numbers, and CPET risk framing.
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Perioperative fluid & goal-directed therapy
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Viva Stems
- Quote Hahn's volume-kinetics numbers — what fraction of crystalloid stays intravascular during versus 30 minutes after infusion? [1]
- Michard studied whom, and what 13% threshold with what sensitivity/specificity? Why can you not quote it for elective cases? [2]
- OPTIMISE: 734 of whom, where, what algorithm, what primary numbers including the p-value? [3]
- RELIEF: 3,000 of whom, what volumes, what disability-free and AKI numbers? [4]
- What does Older's CPET review actually own — and what numbers does it not carry? [5]
- Warm vasodilated hypotension after induction — pressor or litre, and why? (Taught.)
- Oliguric but euvolaemic on flow monitoring — walk me through the no-auto-bolus logic. (Taught.)
- Why is HES not routine, and what is the crystalloid default? (Taught; Hahn persistence 2–3 h for colloids.[1])
References5ShowHide
- [1]Hahn RG Understanding volume kinetics. Acta Anaesthesiol Scand, 2020.PMID 31863457
- [2]Michard F, Boussat S, et al. Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med, 2000.PMID 10903232
- [3]Pearse RM, Harrison DA, et al. Effect of a perioperative, cardiac output-guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery. JAMA, 2014.PMID 24842135
- [4]Myles PS, Bellomo R, et al. Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery. N Engl J Med, 2018.PMID 29742967
- [5]Older PO, Levett DZH, et al. Cardiopulmonary Exercise Testing and Surgery. Ann Am Thorac Soc, 2017.PMID 28511024