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An accurate assessment of intravascular volume status and its management is challenging, and there have been many debates over the topic through the years. The clinical assessment of a patient’s intravascular volume is very challenging and controversial. However, the maintenance of euvolemia is critical to electrolyte homeostasis and oxygen delivery to the tissues. This chapter reviews physiological background and various modalities on assessment of fluid responsiveness. The modalities include central venous pressure (CVP), pulmonary artery occlusion pressure (PAOP), esophageal Doppler, pulse pressure variation, and pulse contour analysis. This chapter further discusses goal-directed therapies and the controversies surrounding fluid management strategies.