Chong MA, et al. - Whether peri-operative goal-directed therapy offers decreased mortality and morbidity in adult surgical patients, was determined by analyzing data from randomised controlled trials reporting the benefits of goal-directed therapy or standard care in adult surgical patients. Trauma patients and parturients were excluded. Analysis of 95 randomised trials (11,659 patients) provided low to very low-quality evidence (e.g. Grading of Recommendations, Assessment, Development and Evaluation scoring) demonstrating that reduced morbidity and mortality was achieved with peri-operative modern goal-directed therapy. Much clinical heterogeneity was reported among the goal-directed therapy devices and protocols.