It is imperative that anesthesiologists are well versed in modifications to fluid management for the elderly patient.1 This chapter discusses the guiding principles in fluid management and the important alterations in kidney function and fluid homeostasis in the elderly patient. These concepts are built upon to provide recommendations for the perioperative period. Preoperative evaluation, assessment, and decision making in the intraoperative period are discussed below, including methods of monitoring intraoperatively, types of fluids to administer, and the use of blood transfusions. Special anesthetic challenges such as spinal anesthesia and fluid management are also included.
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