I am Fabio Taccone from Brussels, Belgium. When you look at real patients—and not just models—undergoing CPH (continuous purification therapies) and measured for antibiotic concentrations, what you find is striking: there is huge variability in how these drugs behave. I was invited to speak about the association between fluids and fluid overload, specifically in relation to pharmacokinetics—the study of how drug concentrations change over time in the body. I shared two key messages with the audience: Pharmacokinetics in critically ill patients is highly unpredictable. In the ICU, we often administer therapies without fully understanding how these drugs are processed. Critical illness alters drug behavior—absorption, distribution, metabolism, and clearance—and we cannot always predict how much of the drug will reach its target. Fluid therapy can significantly alter drug concentrations. When we administer fluids, we're not just "filling the tank"—we're expanding the volume of distribution for many drugs. This can dilute plasma concentrations and, in some cases, increase drug clearance. In other words, fluid management directly affects the effectiveness of antibiotic therapy and other medications. The big takeaway is this: when we measure drug concentrations in actual ICU patients—outside of pharmacokinetic models—the variability is enormous. You cannot rely on standard dosing or one-size-fits-all assumptions. What works in theory or in stable patients may not work at all in critically ill individuals. This highlights the importance of Therapeutic Drug Monitoring (TDM) in the ICU. If we truly want to personalize therapy and improve outcomes, we must measure and adjust based on real-time pharmacokinetics, not outdated models. This meeting has been a great platform for these kinds of discussions. It's a focused congress—dedicated entirely to fluids—allowing us to explore specific aspects of fluid management that often get overlooked in larger general conferences. It's also a fantastic opportunity to network, meet colleagues and friends, and hear the latest research and thinking in this evolving field. The meeting is clearly growing in participation, the organization is excellent, and the location is ideal. It's a pleasure to be part of it.

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