الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
At least 310 million patients undergo major surgery procedures worldwide yearly, that involve the administration of intravenous fluids. The health-care protocols have traditionally advised for large amounts of intravenous fluids administration perioperatively. On the other hand, fluid restriction could increase the risk of hypotension and decrease perfusion in the kidney and other vital organs, leading to organ dysfunction. As a result, the most effective intravenous-fluid regimen is still unclear.
The perioperative fluid therapy has recently focused on three strategies, fixed high- , low-volume regimens, and individualized optimization strategies, so-called goal-directed therapy (GDT), assisted by routine and advanced cardiovascular monitoring.
The goal-directed strategy is based on the hypothesis that perioperative fluid management should contribute to the maximization of oxygen delivery through well-defined goals for therapy, based on flow-related parameters. Furthermore, an individualized approach has been introduced with the maximization of flow-related variables, such as the stroke volume (SV) of the heart, by fluid challenges.
The ability to evaluate intravascular volume is an important part of perioperative fluid management. Insufficient intravascular volume can result in a decline in oxygen delivery to tissues and oxygenation dysfunction, while fluid overload states can contribute to the occurrence of oedema and organ dysfunction, including respiratory failure. The injudicious use of vasopressors and inotropes in the hypovolemic patients can be dangerous and raise the risk of a poor outcome.
The concepts euvolemia and fluid responsiveness are the concepts relevant to evaluation of fluid status in perioperative and critical care. Fluid responsiveness is a strategy put to identify patients who will respond with a positive reaction in a physiologic parameter upon fluid administration. Curiously, there is no generally accepted definition of fluid responsiveness. A provisional parameter of a certain size to a standardized volume of a certain type of fluid administrated within a certain amount of time and measured within a certain interval.