Goal-Directed Fluid Therapy

Goal-directed fluid therapy is the administration of fluid, vasopressors, and inotropes to optimize hemodynamic parameters for better tissue perfusion. Current practice uses cardiac output, systolic, or pulse pressure variations as the targets to follow. However, none of these measures indicate cerebral physiology. Electroencephalogram, evoked potentials, and cerebral oximetry may be used to guide fluid therapy. Nevertheless, the evidence for these monitors to improve patient outcomes remains inconclusive. There are numerous barriers in implementing goal-directed fluid therapy during anesthesia and caring for critically ill patients. Further trials should define the goals to target, and feasibility in implementing protocol. More trials are required to define the benefit and risk ratio in adopting the goal-directed fluid therapy in specific patient populations.