“When in doubt, give fluids and kill your patient”

Abstract

The art of giving the correct amount of intravenous fluids is a very important part of anesthetic management. Intraoperative liberal fluid management during surgery, particularly during major abdominal surgery, has been the golden standard until the beginning of the 21st century. Recent studies and insights have shifted our fluid management towards a more conservative regimen. However, due to conflicting conclusions, heterogeneous studies and a variety of existing fluids, there is still no consensus about the optimal amount and composition to administer. This editorial will give a historical overview on fluid therapy in major abdominal surgery and the currently available evidence. The daily practice, of course, raises a number of questions, and the important ones out of these will be discussed.