Hydroxyethyl Starches

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Abstract
A RECENT systematic review of randomized clinical studies on the use of fluid therapy in various types of surgical procedures found no evidence to recommend one type of fluid therapy over another. Neither was there sufficient evidence to provide guidance on the optimal amount of fluid to use in elective surgical procedures.1 It was therefore concluded that guidelines for perioperative fluid management must be procedure- specific; in the absence of firm evidence for one approach or another, individualized, goal-directed fluid administration should be used. Currently, it appears that a restrictive rather than a liberal fluid regimen is beneficial in patients undergoing colorectal surgery. Conversely, patients suffering from systemic inflammation appear to benefit from “aggressive” fluid replacement, as demonstrated by Rivers et al. 2 and as supported by the current sepsis guidelines.3