DOI: 10.4103/bjoa.bjoa_287_25 ISSN: 2549-2276

Knowledge, Preferences, and Practices in Intravenous Fluid Management among Anesthesiologists in Indonesia: A National Cross-Sectional Survey

Noor Hafidz, Sidharta Kusuma Manggala, Dita Aditianingsih, Asep Hendriana, Ahmad Irfan, Faisal Muchtar, Prananda Surya Airlangga, Bram Kilapong, Septian Adi Permana, Arie Zainul Fatoni, Marilaeta Cindryani, Nurita Dian Kestriani, Bastian Lubis, Ferry Valentino, Jonathan Wiradinata, Celine Kurniawan, Fransiskus Mikael Chandra, Adrian Wong, Manu L. N. G. Malbrain
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Abstract

Background:

Intravenous (IV) fluid therapy is a cornerstone of perioperative and critical care, yet inappropriate fluid selection and administration are associated with adverse outcomes. Fluid stewardship aims to optimize fluid type, dose, and timing; however, data on clinicians’ knowledge and practices in low- and middle-income countries remain limited. This study evaluated knowledge, preferences, and self-reported practices related to IV fluid management among anesthesiologists and anesthesia residents in Indonesia.

Materials and Methods:

A national, cross-sectional online survey was conducted between July and August 2023. Anesthesiology residents, non-intensivist anesthesiologists, and anesthesiology-intensivists were recruited through professional societies and training programs. The survey, adapted from the International Fluid Academy instrument, comprised 67 items, with knowledge scores expressed as percentages. Data were analyzed using descriptive statistics and non-parametric tests.

Results:

A total of 372 respondents from 31 provinces were included. The overall median knowledge score was 35.7% (interquartile range: 28.6–42.9), with significant differences between clinician groups ( P < 0.001). Residents achieved higher scores than practicing anesthesiologists, while non-intensivist anesthesiologists scored lowest. Knowledge scores did not increase with years of professional experience. Balanced crystalloids, particularly Ringer’s lactate, were the preferred initial resuscitation fluids. Fewer than half of respondents reported the presence of hospital-specific fluid protocols, and monitoring practices varied widely.

Conclusions:

Knowledge of IV fluid management among Indonesian anesthesiologists and trainees is suboptimal, with considerable variability in practice and limited institutional guidance. These findings support the need for national fluid stewardship guidelines, structured continuing education, and multidisciplinary stewardship initiatives to improve the safety and consistency of fluid therapy.

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