Balanced Infusion Therapy in the Perioperative Period. Methods of Fluid Resuscitation of Perioperative Blood Loss
Infusion therapy has been one of the main instruments of influence on homeostasis in critical conditions of different nature. Currently, infusion therapy is an essential component of anesthetic and intensive care. However, improper restoration of fluid balance was a major cause of mortality in intensive care units and post-operative intensive care in the 80th of XX century. The appointment of any infusion media is an intervention into the internal environment of the body, that in a greater or lesser degr ee affects the performance of water-salt metabolism, acid-base balance, osmolarity. The surgery itself causes extravasation of fluid. Crystalloid infusion in patients during abdominal surgery resulted in a decreased cardiac output in half of patients. It is believed that the creation of intravascular normovolemia during surgery protects the endothelial glycocalyx from inflammatory mediators in pathological changes, minimizes transcapillary exchange fluid by maintaining proteins endothelial glycocalyx. Restrictive regime of intravenous fluid administration significantly reduces the risk of postoperative complications. In surgical patients of high risk target controlled infusion therapy is suitable. Currently, there is no complete understanding of the pathophysiology of increased vascular permeability and microcirculation disorders in sepsis. In addition, there is a lack of adequate studies, ultimate tests of substitution fluid therapy. Voliutenz is a drug of choice for correction of disorders of circulatory homeostasis during the perioperative period, complicated by hemorrhage.