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PERIOPERATIVE INFUSION THERAPY AS A COMPONENT OF ENHANCED RECOVERY AFTER SURGERY (ERAS) IN CHILDREN

Abstract

The integration of Enhanced Recovery After Surgery (ERAS) protocols into pediatric practice is considered a key factor in improving the safety and effectiveness of surgical treatment. The aim of this review is to systematically analyze modern strategies of perioperative infusion therapy in children within the ERAS framework. Particular attention is given to methods for assessing body fluid compartment distribution, including the potential and safety profile of bioimpedance analysis in the pediatric population. The critical role of maintaining euvolemic status at all stages of perioperative management is emphasized in order to minimize the risk of complications such as capillary leak, interstitial edema, and organ dysfunction. It is concluded that goal-directed infusion therapy, based on adequate monitoring, represents a fundamental component of enhanced postoperative recovery in children undergoing major surgical interventions.

Keywords

ERAS (Enhanced Recovery After Surgery), perioperative period, infusion therapy, pediatric population, bioimpedance analysis

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References

  1. Сатвалдиева Э.А., Шакарова М.У., Маматкулов И.Б., Исмаилова М.У. Использование fast-track в детской урологии // Урология. – 2022. – № 4. – С. 52-55.
  2. Rafeeqi T., Pearson E.G. Enhanced recovery after surgery in children // Transl Gastroenterol Hepatol. – 2021. – Vol. 6. – P. 46. doi: 10.21037/tgh-20-188.
  3. Noba L., Rodgers S., Chandler C., Balfour A. Enhanced Recovery After Surgery (ERAS) Reduces Hospital Costs and Improve Clinical Outcomes in Liver Surgery: a Systematic Review and Meta-Analysis // J Gastrointest Surg. – 2020. – Vol. 24, № 4. – P. 918-932. doi: 10.1007/s11605-019-04499-0.
  4. Brindle M.E., Heiss K., Scott M.J. Embracing change: the era for pediatric ERAS is here // Pediatric Surgery International. – 2019. – Vol. 35. – P. 631-634.
  5. Camacho Navarro L.H., Bloomstone J.A. Perioperative fluid therapy: a statement from the international Fluid Optimization Group // Perioper Med (Lond). – 2015. – Vol. 4. – P. 3. doi: 10.1186/s13741-015-0014-z.
  6. Zhu A.C., Agarwala A., Bao X. Perioperative Fluid Management in the Enhanced Recovery after Surgery (ERAS) Pathway // Clin Colon Rectal Surg. – 2019. – Vol. 32, № 2. – P. 114-120. doi: 10.1055/s-0038-1676476.
  7. Miller T.E., Roche A.M., Mythen M. Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS) // Canadian Journal of Anesthesia. – 2015. – Vol. 62. – P. 158-168.
  8. Myles P.S., Andrews S., Nicholson J. et al. Contemporary Approaches to Perioperative IV Fluid Therapy // World J Surg. – 2017. – Vol. 41, № 10. – P. 2457-2463. doi: 10.1007/s00268-017-4055-y.
  9. Becker B.F., Chappell D., Jacob M. Endothelial glycocalyx and coronary vascular permeability: the fringe benefit // Basic Res Cardiol. – 2010. – Vol. 105. – P. 687-701. doi: 10.1007/s00395-010-0118-z.
  10. Chappell D., Jacob M., Hofmann-Kiefer K., Conzen P. A rational approach to perioperative fluid management // Anesthesiology. – 2008. – Vol. 109, № 4. – P. 723-740. doi: 10.1097/ALN.0b013e3181863117.
  11. Brandstrup B., Tonnesen H., Beier-Holgersen R. Effects of Intravenous Fluid Restriction on Postoperative Complications: Comparison of Two Perioperative Fluid Regimens // Annals of Surgery. – 2003. – Vol. 238, № 5. – P. 641-648. doi: 10.1097/01.sla.0000094387.50865.23.
  12. Brandstrup B., Svendsen P.E., Rasmussen M. 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. – Vol. 109. – P. 191-199. doi: 10.1093/bja/aes163.
  13. Lewis S.J., Egger M., Sylvester P.A., Thomas S. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials // BMJ. – 2001. – Vol. 323 (7316). – P. 773-776. doi: 10.1136/bmj.323.7316.773.
  14. Altman A.D., Helpman L., McGee J. Enhanced recovery after surgery: implementing a new standard of surgical care // CMAJ. – 2019. – Vol. 191, № 17. – E469-E475. doi: 10.1503/cmaj.180635.
  15. Miller T.E., Roche A.M., Mythen M. Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS) // Canadian Journal of Anesthesia. – 2015. – Vol. 62. – P. 158-168.
  16. Zoremba N., Homola A., Rossaint R., Syková E. Interstitial lactate, lactate/pyruvate and glucose in rat muscle before, during and in the recovery from global hypoxia // Acta Vet Scand. – 2014. – Vol. 56, № 1. – P. 72. doi: 10.1186/s13028-014-0072-0.
  17. Vincent J.L., De Backer D. Circulatory shock // N Engl J Med. – 2013. – Vol. 369, № 18. – P. 1726-1734. doi: 10.1056/NEJMra1208943.
  18. Proulx F., Lemson J., Choker G., Tibby S.M. Hemodynamic monitoring by transpulmonary thermodilution and pulse contour analysis in critically ill children // Pediatr Crit Care Med. – 2011. – Vol. 12, № 4. – P. 459-466. doi: 10.1097/PCC.0b013e3181fe32b1.

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