Learning objectives: Understand the nature of the complications that arise when more crystalloid fluid is being administered. Be aware of the revised Starling equation and the implications of the endothelial glycocalyx layer. Know the "normal" intravascular persistence times of crystalloids and colloids fluids.
Take home messages:
Many small studies show that complications increase when more than 3 L of crystalloid fluid is administered.
The damage to the endothelial glycocalyx layer in response to surgery seems to be small.
1. Hahn RG. Fluid and electrolytes physiology in anaesthetic practice. In: Hardman J, Hopkins P, Struys M. Oxford Textbook of Anaesthesia. Oxford University Press 2017, pp. 49-57.
2. Woodcock TE. Plasma volume, tissue oedema, and the steady-state Starling principle. BJA Education 2017; 17: 74-78.
3. Hahn RG. Adverse effects of crystalloid and colloid fluids. Anaesthesiol Intensive Ther 2017; 49: 303-308.