Approach to perioperative fluid management, fluid preference and hypotension: National survey

OBJECTIVE: We aimed to define the preferences and tendency about perioperative fluid management and the methods and treatments they use in patients who develop hypotension by questioning the Anesthesiology and Reanimation specialist in Turkey MATERIAL AND METHODS: Our survey study, obtained by collecting data via electronic data form over the web, was carried out between October 21,2019 and February 01, 2020. The survey consists of a total of 42 questions. There are 6 questions with demographic data in section A, 4 questions including institution and practitioner information in section B and 32 questions including data on perioperative fluid management, fluid preference, and approach to hypotension in section C. The data obtained were analyzed using SPSS program, Variance Analysis, Post Hoc (Bonferroni) tests and Independent Samples Test. Differences between distributions were investigated with chi-square test methods. The difference between the groups was considered statistically significant if the p value was less than 0,05. RESULTS: Responses to our survey were received from 209 Anesthesiology and Reanimation specialists across Turkey. Physicians' demographic data, institutional information, data of perioperative fluid management, fluid preference and approach to hypotension were obtained. Most of the participants reported that there was no written fluid management protocol / guideline or consensus in their institution. The most preferred liquid type in daily practice is crystalloid and their most preferred haemodynamic monitoring methods are invasive arterial pressure and central venous pressure monitoring. The participants stated that main factors affecting fluid management preferences are avoiding excessive fluid overload and preventing kidney failure. Half of the participants stated that they preferred fluid replacement as the first approach in hypotension developed intraoperatively. Ephedrine, norepinephrine and dopamine were seen to be the most preferred catecholamines in daily practice. CONCLUSION: There are publications related to Anesthesiology and Reanimation specialist's perioperative fluid management preferences and the approaches to hypotension in Turkey and in the world however, there is no publication examining this issue in general and as a whole. Our study is the only detailed survey study that covers data on this. The data obtained from our study shows that Obtaining and tightening the use of current technologies in perioperative fluid management are needed. KEY WORD: Perioperative fluid management, Perioperative hypotension, Hemodynamic monitoring methods, Survey