Affiliation:
1. Division of Plastic Surgery, Department of Surgery University of Florida Gainesville Florida USA
2. College of Medicine University of Florida Gainesville Florida USA
3. Stanford University School of Medicine Stanford California USA
4. Department of Anesthesiology University of Florida Gainesville Florida USA
5. The Buncke Clinic San Francisco California USA
Abstract
AbstractBlood pressure regulation is critical in patients undergoing microsurgical free tissue transfer; however, guidelines for addressing and preventing perioperative hypotension remain highly debated, with two current thought paradigms: (1) intravenous fluid administration with a balanced salt solution (e.g., lactate ringer and normal saline) and/or colloid (e.g., albumin) and (2) vasoactive pharmacological support with vasopressors (e.g., dobutamine, norepinephrine, epinephrine), with fluid administration being the preferred conventional approach. Here, we review the most up to date available literature and summarize currents perspectives and practices for fluid resuscitation and vasopressor use, while offering evidence‐based guidelines to each.