I'm Jules Wendon, and my talk was about fluid therapy in patients with liver disease. When managing a patient with cirrhosis, getting the volume status just right is critical—not too little, and not too much. An underfilled patient is at significant risk, as inadequate perfusion can worsen organ function. But overfilling is equally harmful. It can exacerbate edema, increase liver stiffness, and aggravate portal hypertension. Both extremes are dangerous. In addition to careful fluid management, vasoconstrictors—particularly splanchnic vasoconstrictors—play a vital role. They help redistribute blood centrally, improve effective circulating volume, and counteract the central hypovolemia often seen in these patients. Ultimately, it's all about balance. A little bit of this, a little bit of that. You need to take a step back and look at the whole picture. A holistic and nuanced approach is key to optimal patient care.

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