I am Joel Starkopf from Estonia, and I believe we have to start by looking at the patient in front of us. You can't impose a rigid mandate that every single patient must receive fluids, every time, without exception. Clinical decisions must be individualized, not protocol-driven for the sake of simplicity. This is why meetings like this one are so valuable. It's a well-publicized and well-organized congress, held in a beautiful setting here at the Hilton Hotel in Antwerp. But more importantly, it's a place where experts and colleagues come together in a friendly and collaborative atmosphere to discuss what may seem like simple aspects of care—fluids and nutrition—but are in fact incredibly complex and nuanced topics. We've seen something similar with oxygen therapy in recent years. At one point, oxygen was given almost reflexively to nearly every patient. Then the evidence shifted, and new guidelines advised against routine oxygen use unless truly indicated. But in some cases, we've now swung too far the other way, seeing underuse of oxygen in patients who actually need it. We must be careful not to repeat the same mistakes with fluids. For a long time, both fluid therapy and nutrition were neglected or treated as routine interventions—something basic and not worth much attention. But recent research has made it clear: it's not that simple. Fluids are drugs. And like any drug, they come with potential side effects, risks, and benefits. We need to carefully consider the type of fluid, the dose, and the clinical context. That's why it's so enriching to gather here and discuss these subtle but important issues in critical care.

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