medicina59巻5号

2022年04月発行

特集 症例から学ぶ—電解質と体液量管理のベストアンサー 体液量の管理

周術期—非制限的輸液管理・ゼロバランス輸液管理

著者： 坂本安優¹ 小竹良文¹

所属機関： ¹東邦大学医療センター大橋病院麻酔科

ページ範囲：P.716 - P.720

症例1
75歳男性，体重60kg
進行胃がんに対して開腹幽門側胃切除術が予定された．消化管通過障害はなく，経口摂取も十分行えていた．

参考文献

1）Minto G, et al：Monitoring needs and goal-directed fluid therapy within an enhanced recovery program. Anesthesiol Clinics 33：35-49, 2015

2）Moritz ML, Ayus JC：Maintenance intravenous fluids in acutely Ⅲ patients. N Engl J Med 373：1350-1360, 2015

3）Foss NB, Kehlet H：Perioperative haemodynamics and vasoconstriction；Time for reconsideration? Br J Anaesth 123：100-103, 2019

4）日本輸血・細胞治療学会：科学的根拠に基づいたアルブミン製剤の使用ガイドライン，2015　http://yuketsu.jstmct.or.jp/wp-content/themes/jstmct/images/medical/file/guidelines/1530_guidline.pdf（2021年11月閲覧）

5）Brandstrup B, 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 109：191-199, 2012

6）Myles PS, et al：Restrictive versus liberal fluid therapy for major abdominal surgery. N Engl J Med 378：2263-2274, 2018

7）Miller TE, Myles PS：Perioperative fluid therapy for major surgery. Anesthesiology 130：825-832, 2019

8）小竹良文：術中の輸液管理．循環制御33：13-19, 2012

9）Bellamy MC：Wet, dry or something else? Br J Anaesth 97：755-757, 2006

10）Vincent JL, et al：Perioperative cardiovascular monitoring of high-risk patients；A consensus of 12. Crit Care 19：224, 2015

11）小竹良文：静脈還流と周術期循環管理．臨床麻酔35：989-998, 2011

12）Zarbock A, et al：Update on perioperative acute kidney injury. Anesth Analg 127：1236-1245, 2018

13）Mizota T, et al：Intraoperative oliguria predicts acute kidney injury after major abdominal surgery. Br J Anaesth 119：1127-1134, 2017

14）Sessler DI, et al：Perioperative quality initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. Br J Anaesth 122：563-574, 2019

15）Cannesson M, Gan TJ：PRO；Perioperative goal-directed fluid therapy is an essential element of an enhanced recovery protocol. Anesth Analg 122：1258-1260, 2016

16）Biais M, et al：Case scenario；Respiratory variations in arterial pressure for guiding fluid management in mechanically ventilated patients. Anesthesiology 116：1354-1361, 2012

17）Bentzer P, et al：Will this hemodynamically unstable patient respond to a bolus of intravenous fluids? JAMA 316：1298-1309, 2016

18）Marik PE, et al：Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest 134：172-178, 2008