🎙️ Live from IFAD – Friday Afternoon We caught up with Dr. Jan just after his session on a crucial—yet often overlooked—topic: the dangers of de-resuscitation. 🗣️ "Yes, I spoke about de-resuscitation, or what's also called fluid de-escalation or fluid removal. The first thing we need to do is really understand what it is—and why it's important. It typically comes at the very end of resuscitation, which might be why it doesn't always get the attention it deserves." While many clinicians rely on cumulative fluid balance numbers, biomarkers, and hemodynamic indices, Jan emphasizes a critical point: 👀 "Look at the patient. Don't just rely on numbers. Look for clinical signs of fluid overload and even fluid toxicity. Before you start removing fluid, make sure you have a clear clinical reason—such as unresolved respiratory failure or acute kidney injury that could be linked to fluid accumulation." So how does Jan decide when to start de-resuscitation? 🤔 "It's difficult. There's no biomarker for it. You need to make a clinical judgment. Many people wait for the patient to become hemodynamically stable or to be off vasopressors—but actually, in my experience, fluid removal can often be tolerated even with low-dose vasopressors. That shouldn't be seen as an absolute barrier." ✅ Key takeaway: There's no one-size-fits-all solution. The decision to de-resuscitate should be based on the full clinical picture, not just fluid balance sheets. 👏 Thanks to Jan for sharing these important insights! 📍 Stay tuned for more from #IFAD2017 #FluidTherapy #DeResuscitation #CriticalCare #FOAMed

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