Background: Goal-directed fluid therapy (GDFT) has been shown to reduce complications and hospital length of\r\nstay following major surgery. However, there has been no assessment regarding its use in clinical practice.\r\nMethods: An electronic survey was administered to randomly selected anaesthetists from the United Kingdom\r\n(UK, n = 2000) and the United States of America (USA, n = 2000), and 500 anaesthetists from Australia/New Zealand\r\n(AUS/NZ). Preferences, clinical use and attitudes towards GDFT were investigated. Results were collated to examine\r\nregional differences.\r\nResults: The response rates from the UK (n = 708) and AUS/NZ (n = 180) were 35%, and 36% respectively. The\r\nresponse rate from the USA was very low (n = 178; 9%). GDFT use was significantly more common in the UK than in\r\nAUS/NZ (p < 0.01). The Oesophageal Doppler Monitor was the most preferred instrument in the UK (n = 362; h76%)\r\nwith no clear preferences in other regions. GDFT was most commonly utilised in major abdominal surgery and for\r\npatients with significant comorbidities. The commonest reasons stated for not using GDFT were either lack of\r\navailability of monitoring tools (AUS/NZ: 57 (70%); UK: 94 (64%)) or a lack of experience with instruments (AUS/NZ:\r\n43 (53%); UK: 51 (35%)). A subset of respondents (AUS/NZ: 22(27%); UK: 45 (30%)) felt GDFT provided no perceived\r\nbenefit. Enthusiasm towards the use of GDFT in the absence of existing barriers was high.\r\nConclusion: Several hypotheses were generated regarding important differences in the use of GDFT between\r\nanaesthetists from the UK and AUS/NZ. There is significant interest in utilising GDFT in clinical practice and existing\r\nbarriers should be addressed.
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