Perioperative fluid therapy: a statement from the international Fluid Optimization Group.

Area of Science:

• Anesthesiology and Critical Care Medicine
• Physiology
• Pharmacology

Background:

• Perioperative fluid therapy is debated, aiming to maintain circulating blood volume.
• Risks of overhydration and underhydration are significant, alongside potential inaccuracies in assessing patient fluid status.
• Current practices in fluid administration show wide variability among institutions and practitioners.

Purpose of the Study:

• To define the risks and benefits of various fluid choices in the perioperative setting.
• To describe evidence-based methodologies for perioperative fluid administration.
• To reduce variability in perioperative fluid management practices.

Main Methods:

• Convened the international Fluid Optimization Group (FOG) in 2011, comprising 14 researchers from 7 countries.
• Conducted a collaborative review of 162 fluid resuscitation papers.
• Synthesized data over 3 years to analyze risks, benefits, and administration methods of perioperative fluids.

Main Results:

• An overview of components for effective perioperative fluid administration plans was developed.
• Physiologic principles and outcomes associated with fluid administration were addressed.
• Key considerations for optimizing fluid therapy were identified.

Conclusions:

• Perioperative fluid choice and therapy should be individualized.
• Fluid administration should be guided by predefined physiological targets.
• Fluids are recommended for patients needing perfusion augmentation and who are volume responsive.