Análise da gestão de fluidos perioperatórios em cirurgias de grande porte não cardíacas realizadas em adultos na cidade de Manaus

Abstract

The management of perioperative fluids begins with the preoperative identification of the physical and volume status of the patient and its optimization for the performance of the surgical procedure. The objectives of the study were to evaluate the knowledge of hemodynamic processes and fluid management practices in major non-cardiac surgeries by anesthesiologists in the city of Manaus/AM and compare the results obtained with the current literature. After approval by the Research Ethics Committee of the Federal University of Amazonas (CAAE: 59500522.4.0000.9167), a descriptive and cross-sectional observational study was carried out, with the application of an online questionnaire to anesthesiology residents and anesthesiologists in the city of Manaus. A total of 124 physicians participated in the survey, 107 anesthesiologists (86.3%) and 17 anesthesiology residents (13.7%). Most fully agreed with the importance of preoperative evaluation of patients (96%) and the goal-oriented strategy (93.5%) for reducing morbidity and mortality, but only 74.2% of participants declared adopting this strategy. Cardiopulmonary decompensation is considered the major adverse event (81.5%) in the liberal strategy, while in the restrictive one acute kidney injury is considered (54.8%). One hundred and twenty-one participants (87.9%) agreed with the need for a guideline for the management of perioperative fluids in major surgeries, as the majority (98.3%) stated that there are no perioperative hydration protocols in their services . The knowledge and practices of perioperative fluid management in major non-cardiac surgeries of the study participants, for the most part, are consistent with the practices described in the current literature, with recognition of the need for institutional management protocols.