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Fluid management of patients undergoing major bowel surgery has been debated during the last few years. The concept of individualised Goal Directed Therapy (GDT), optimising stroke volume with boluses of fluid, has replaced the previous debate about ‘restrictive’ or ‘liberal’ regimes and has been found to improve outcome. GDT targeting stroke volume is now recommended as standard practice in the UK. The best validated monitor in this context is the oesophageal Doppler.This survey was conducted to obtain information about how these findings are being incorporated into current practice in Sweden. All hospitals in Sweden conducting major bowel surgery were contacted and the responsible anaesthetist at each was asked to complete a questionnaire concerning the management of this type of patient in their department. Forty two completed questionnaires were received and analysed (81% response rate). Responding hospitals carry out a total of 200 major bowel surgeries per week on average. All patients are risk stratified using the ASA classification; other ways of identifying high risk patients are very rarely used. All departments own a monitor which could be used for GDT, but only 45% use such monitors routinely. Only 10% use the oesophageal Doppler. The perioperative management of patients undergoing major bowel surgery in Sweden could be improved as this survey shows that adoption of research findings into clinical practice is poor. Further work should be done to find out why this is the case.

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