title: Fluid management in thoracic surgery.
abstract: OBJECTIVE
  This review presents the current available data to date regarding the perioperative risks associated with fluid management in thoracic surgery and its implications on the development of acute lung injury (ALI) as well as acute kidney injury (AKI).
  
  
  RESULTS
  The debate over the adequate fluid management during lung resection surgery has not been settled. Recent findings question the relationship between fluid administration and the development of ALI after lung resection surgery. New concepts including the capillary glycocalyx and the 'baby lung' model have reshaped thinking and therapy. Currently, there has been a growing interest in tissue hypoperfusion resulting from inadequate fluid resuscitation and the development of AKI after lung resection surgery.
  
  
  CONCLUSIONS
  Alternative fluid regimens to the traditional restrictive protocols used during thoracic surgery are being explored. These include normovolemic and goal-directed therapy protocols and the use of newer colloid solutions.
authors.affiliation: VA Healthcare Systems, Yale University School of Medicine, New Haven, Connecticut, USA. Sherif.assaad@yale.edu
authors.forename: Sherif
authors.initials: S
authors.lastname: Assaad
authors.forename: Wanda
authors.initials: W
authors.lastname: Popescu
authors.forename: Albert
authors.initials: A
authors.lastname: Perrino
mesh_terms: D058186:Acute Kidney Injury / Q000517:prevention & control; D055371:Acute Lung Injury / Q000517:prevention & control; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D008168:Lung / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D011654:Pulmonary Edema / Q000517:prevention & control; D019616:Thoracic Surgical Procedures / Q000379:methods*; D055397:Ventilator-Induced Lung Injury / Q000517:prevention & control