Open Access Highly Accessed Debate

Liberal or restricted fluid administration: are we ready for a proposal of a restricted intraoperative approach?

Giorgio Della Rocca, Luigi Vetrugno*, Gabriella Tripi, Cristian Deana, Federico Barbariol and Livia Pompei

Author Affiliations

Dipartimento di Scienze Mediche Sperimentali e Cliniche, University of Udine, University of Udine, 33100 Udine, Italy

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BMC Anesthesiology 2014, 14:62  doi:10.1186/1471-2253-14-62

Published: 1 August 2014



Fluid management in the perioperative period has been extensively studied but, despite that, “the right amount” still remains uncertain. The purpose of this paper is to summarize the state of the art of intraoperative fluid approach today.


In the current medical literature there are only heterogeneous viewpoints that gives the idea of how confusing the situation is. The approach to the intraoperative fluid management is complex and it should be based on human physiology and the current evidence.


An intraoperative restrictive fluid approach in major surgery may be beneficial while Goal-directed Therapy should be superior to the liberal fluid strategy. Finally, we propose a rational approach currently used at our institution.

Fluid management; Liberal versus restricted; Colloid versus crystalloid; Intraoperative fluid