Intended for healthcare professionals


Intravenous fluids in adults undergoing surgery

BMJ 2009; 338 doi: (Published 24 June 2009) Cite this as: BMJ 2009;338:b2418
  1. Bette Liu, senior research fellow,
  2. Simon Finfer, professor
  1. 1George Institute for International Health, University of Sydney, Sydney, NSW 2000, Australia
  1. sfinfer{at}

    High quality research is needed before guidelines can be reliable and useful

    The publication of British consensus guidelines on intravenous fluid therapy for adult surgical patients is a welcome and overdue recognition of the importance of this treatment.1 This recognition is timely, because emerging evidence indicates that the choice of fluid and resuscitation protocol may materially affect patients’ outcomes.2 3 4

    Clinical practice guidelines that are well conceived, researched, and written help clinicians provide the best evidence based care. They also help policy makers, clinicians, and patients by providing a benchmark for appropriate practice, and researchers and research funding agencies by identifying gaps in evidence where research is needed. To achieve these goals, guidelines must meet certain quality standards—their scope and purpose should be clearly articulated, they should be based on systematic review of all the relevant primary literature, the search strategies used should be provided for critique, and the criteria by which studies are included or excluded and by which the quality of evidence is rated should be described.5 6

    The British consensus guidelines fall short of attaining these goals. The stated aim of the guidelines …

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