Perioperative Fluid Manangement

A perioperative clinician should have in-depth knowledge about the composition of body fluids, effects of metabolic stress response on fluid shifts and the indications for timely de-resuscitation. Over the years, the principles of perioperative fluid management have largely focussed on aggressive fluid administration without checks thereby ignoring many harmful side effects. To achieve a good surgical outcome, fluid therapy based on checks and balances is an absolute necessity. Overzealous administration of large volumes of any fluid can lead to more harm than benefit. Hence, the current practice is to individualize the fluid therapy based upon need which can be assessed dynamically by a large number of gadgets. While research about liberal versus restrictive approaches has often yielded divergent results, the benefits of a goal-directed therapy has remained equivocal. The type and duration of the surgery largely influence fluid balance and their understanding is pivotal towards patient safety.