• Giovanni Mariscalco and Francesco Musumeci.
• aDepartment of Heart and Vessels, Cardiac Surgery Unit, Varese bDepartment of Cardiac Surgery and Transplantation, S. Camillo Hospital, Rome, Italy.
• Curr Opin Anaesthesiol. 2014 Apr 1;27(2):133-9.

Purpose Of ReviewThe present review discusses the current concepts of fluid management in cardiothoracic surgery, and its clinical implications with special reference to organ-related complications and their prevention.Recent FindingsCurrent strategies in fluid management for cardiothoracic patients, various fluid formulation, and the preventive strategies for minimizing fluid-related complications are described, with particular reference to new discoveries and controversies that have arisen from recent literature.SummaryThe optimal fluid management in cardiothoracic patients has not been settled. Results of recent clinical published trials highlight the need for minimizing fluid administration and attempting to use diuretics to achieve a negative fluid, although hypovolemia and hypoperfusion should be carefully considered. An individualized optimization of fluid status, using goal-directed therapy, has emerged as a possible preferable approach. The old debate between crystalloid and colloid solutions has been partially solved, as some colloids have demonstrated deleterious effect on renal function and coagulation system. Various preventive strategies have also emerged for minimizing fluid-related complications.

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