Ten steps towards better perioperative intravenous fluid therapy ➡️ doi.org/10.1093/bjs/znaf179 💧 IV fluids are drugs — both deficit and overload worsen outcomes, yet perioperative prescribing is often overlooked and delegated to juniors 🩺 The paper stresses ABCDE assessment and clear indication (resuscitation, replacement, maintenance), plus better pre-op hydration with “SipTilSend” ⚖️ Intraoperatively, it advocates balanced crystalloids over 0.9% saline, low-rate background infusions, and goal-directed boluses to avoid salt–water overload 🩸 For bleeding, early 1:1:1 blood product transfusion is advised 🥤 Post-op care focuses on tailored maintenance (≤2–2.5 L/day), early oral intake, and aiming for near-zero or negative fluid balance to reduce complications Work by Michael Ess, Dileep N Lobo @DL08OMD #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BJSOpen @des_winter @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide #some4hpb #some4tpl @DPCG_official @pancreatitis_nl @PancreasClub #PancreasClub2023 #PancreaticCancer #Pancreatitis #HCC @PanCAN#PanCANawareness @EurPancClub @P_C_E_ @dice_europe #PancreaticCancer#cholangiocarcinoma #colorectalsurgery #StepUp4CRC @FightCRC @ACPGBI #ERAS @dice_europe #Crohn #proctology @Dukes_Club @ACPGBI_EduTrain @AECP_FAECP @PelvExGroup @escp_tweets @YouESCP #TeachMeColoproctology #Some4COLoprocto