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Perioper Med (Lond). 2016 Sep 17;5:24. doi: 10.1186/s13741-016-0049-9. eCollection 2016.

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative  (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery.

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Departments of Anesthesiology and Biomedical Engineering, Divisions of Cardiac, Thoracic, and Critical Care Anesthesiology, UVA Enhanced Recovery after Surgery (ERAS) Program, University of Virginia School of Medicine, Charlottesville, VA USA.
Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710 USA.
Duke University and Durham VA Medical Center, Durham, NC USA.
Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH UK.
Division of Surgery and Interventional Science, University College London, Royal Free Hospital, London, NW3 2QG UK ; Anaesthetic Department, Royal Free Perioperative Research Group, Royal Free Hospital, London, NW3 2QG UK.
Department of Surgery, University of Texas-Medical Branch at Galveston, Galveston, TX 77555 USA.
Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA USA.
Department of Anesthesiology, Stony Brook University School of Medicine, Stony Brook, NY USA.
University College London Hospitals, National Institute of Health Research Biomedical Research Centre, London, UK.
Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN USA.
Division of General, Vascular and Transplant Anesthesia, American Society for Enhanced Recovery, Duke University Medical Center, Durham, NC 27710 USA.



Enhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There is some controversy about the adoption of specific elements in enhanced recovery "bundles" because the relative importance of different components of ERPs is hard to discern (a consequence of multiple simultaneous changes in clinical practice when ERPs are initiated). There is evidence that specific approaches to fluid management are better than alternatives in patients undergoing colorectal surgery; however, several specific questions remain.


In the "Perioperative Quality Initiative (POQI) Fluids" workgroup, we developed a framework broadly applicable to the perioperative management of intravenous fluid therapy in patients undergoing elective colorectal surgery within an ERP.


We discussed aspects of ERPs that impact fluid management and made recommendations or suggestions on topics such as bowel preparation; preoperative oral hydration; intraoperative fluid therapy with and without devices for goal-directed fluid therapy; and type of fluid.


Carbohydrate drink; Colloids; Colorectal surgery; Crystalloids; Enhanced recovery pathway; Fluids; Goal-directed fluid therapy; Hemodynamics; Enhanced recovery

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