• Scott C Watkins and Andrew D Shaw.
• aDepartment of Anesthesiology, Division of Pediatric Cardiac Anesthesiology, Monroe Carell Jr. Children's Hospital at Vanderbilt bDepartment of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
• Curr Opin Crit Care. 2016 Dec 1; 22 (6): 527-532.

Purpose Of ReviewThe past decade has seen more advances in our understanding of fluid therapy than the preceding decades combined. What was once thought to be a relatively benign panacea is increasingly being recognized as a potent pharmacological and physiological intervention that may pose as much harm as benefit.Recent FindingsRecent studies have clearly indicated that the amount, type, and timing of fluid administration have profound effects on patient morbidity and outcomes. The practice of aggressive volume resuscitation for 'renal protection' and 'hemodynamic support' may in fact be contributing to end organ dysfunction. The practice of early goal-directed therapy for patients suffering from critical illness or undergoing surgery appears to offer no benefit over conventional therapy and may in fact be harmful. A new conceptual model for fluid resuscitation of critically ill patients has recently been developed and is explored here.SummaryThe practice of giving more fluid early and often is being replaced with new conceptual models of fluid resuscitation that suggest fluid therapy be 'personalized' to individual patient pathophysiology.

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