Perioperative fluid management is one of the primary responsibilities of the anesthesiologist.  It is a key component in maintaining homeostasis in patients undergoing surgery. When perioperative fluid management is not optimized, it can result in significant morbidity and mortality for patients and increased financial burden for hospitals and the entire healthcare system. Cancer patients are a special challenge for anesthesiologists, as they have frequently undergone chemotherapy treatments that affect the function of many organ systems and require judicious fluid management. Several strategies for optimal perioperative fluid management have been extensively studied.  It remains unclear which strategy is most effective.

Anesthesiologists and CRNAs at City of Hope have different fluid management practices that are often based on outdated evidence. As large multicenter studies have been published in recent years, strong data on fluid management strategies has become widely available. The implementation of improved strategies, however, often lags behind.  It is imperative to make fluid management practices more uniform and shorten the time of implementation of strategies that offer improved outcomes for our patients. The lack of consensus guidelines has made perioperative fluid management challenging for the anesthesiologists. As more evidence has become available, practices have shifted.  Recent clinical studies have been published that have advanced knowledge on the efficacy of various strategies.  It is important for anesthesiologists to keep abreast of these key findings so as to be able to provide safe, evidence- based care to patients.