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Updated: Apr 14, 2026

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
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Perioperative fluid therapy: a statement from the international Fluid Optimization Group.

Lais Helena Camacho Navarro1, Joshua A Bloomstone2, Jose Otavio Costa Auler3

  • 1Anesthesiology Department, Botucatu Medical School University of Sao Paulo State - UNESP, District of Rubiao Junior s/n, Botucatu, Sao Paulo, 18618-970 Brazil.

Perioperative Medicine (London, England)
|April 22, 2015
PubMed
Summary

Perioperative fluid therapy requires individualized approaches, balancing risks of under- or overhydration. Administer fluids based on patient-specific physiological targets for optimal organ perfusion.

Keywords:
Fluid responsivenessFluid resuscitationGoal-directed fluid therapyPerioperative fluids

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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.