IFA Talks

I am Dirk Himpe from Antwerp Belgium. Gelatins are still considered the Cinderella of the colloids . Much like the fairytale character, they're often overlooked or spoken about in hushed tones—but they continue to quietly do a great deal of work behind the scenes. And perhaps, like Cinderella, they too have a promising future . Gelatins are actually the oldest synthetic plasma substitutes , with t...

What is the importance of a meeting like this? I am Filip De Somer from Belgium and a meeting like this is incredibly valuable because it focuses on a relatively new technology — ECMO —that is increasingly being adopted outside of university hospitals . As its use expands into more general and community settings, it becomes essential for clinicians to have a clear understanding of both its indicat...

Do you know how long it typically takes for a piece of research to make its way into clinical practice? 16 years. Some say 17. That's an entire generation of medical graduates before evidence becomes routine care. It's far too long—and that's where tools like social media can help bridge the gap. I'm Cian McDermott, an  emergency medicine doctor , and I'm passionate about the use of point-of-care...

Hi, I am Paul Elbers from The Netherlands and it's critically important to base fluid therapy on sound physiological principles , particularly those involving the right heart . You need to be careful when administering fluids and always consider the functional state of the right ventricle . If you give fluids when they're not indicated, you may worsen the patient's condition —the right heart can b...

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-orga...

Lactate is your friend—not your foe. In fact, lactate infusion has been shown to improve cognitive and brain function in patients with traumatic brain injury . Yet, many clinicians still view elevated lactate with alarm, focusing on bringing the number down rather than understanding what it truly represents. I am Paul Marik from the USA, and I gave  three lectures during this conference: One on th...

I am Tom Woodcock from UK and I was once told by a  very well-known professor of anesthesia —someone you'll no doubt hear much more about in the coming decade—that patients die of sepsis because there's no starch left to plug the holes in their capillaries . That statement stuck with me. A few years ago, I decided to step away from clinical practice to fully focus on what I believe are three criti...

So, how do we distinguish a vein from an artery during ultrasound? This is crucial—because, of course, we do not want to puncture an artery. Generally: Veins appear oval on ultrasound and are usually compressible . Arteries are more round and non-compressible , maintaining their shape under pressure. I am Willem Stockman from Belgium and today, I had the opportunity to give two talks : One on ultr...

Hi, I am Ross Fisher from UK. This is a heartfelt and highly relevant reflection on the importance of communication in medicine. Here's a polished and structured version of your transcript, capturing both the vulnerability and the power of your message, suitable for publication, a conference report, or a speaker spotlight: As one of our colleagues rightly pointed out— we're terrified . And trust m...

"Physiology is the only polar star we have." Luciano says it time and again—and he's absolutely right. So when it comes to fluid therapy , we need to begin by grounding ourselves in physiological principles . I am Can Ince form The Netherlands and as a  physiologist , that's my role—to focus on the mechanisms behind what we observe in the clinic. And I often find that clinicians are genuinely curi...

"What you do now—you cut it through." As you do, you'll see a tiny portion of the anterior mitral leaflet , particularly the A2 segment , and just behind it, a glimpse of the posterior leaflet . This is one of the foundational skills we teach in the Point-of-Care Ultrasound (POCUS) Beginners Course at the IFAD Fluid Academy Meeting . I am Adrian Wong from UK, and I am the  course director for this...

Hi, I am Mervyn Singer from UK. There's been  a lot of hype in the literature lately—claims that sepsis incidence is rising , but at the same time, mortality is declining . That sounds like good news, but it's worth taking a closer look. In my talk, I explored the impact of the Sepsis-3 definitions , which were introduced in February 2016 . Now, with more than 20 months of clinical experience and...

I am Daniel Lichtenstein from France. Which ultrasound equipment do we recommend? Actually—none. Every doctor tends to be happy with their own device. If you prefer a laptop-based system, go for it. Personally, since 1992 , I've been using a simple, reliable machine with a universal probe —a single transducer capable of scanning the entire body. And that's more than enough. Today's lecture was par...

This project is still very much in its conceptual stage —what one might call in the mind of God . But we've had a chance to explore a potentially game-changing idea: using renal signals to assess our volemic status . In other words, letting the kidney "judge" whether the patient is adequately filled or not. Everything in this discussion revolves around fluid management —fluid physiology, fluid the...

I am Lui Forni from UK. As a  nephrologist , I can tell you with confidence: sodium is bad for you . If you look at the Yanomami Indians in South America, who have one of the lowest sodium intakes in the world, you'll notice something fascinating. Their systolic blood pressure rarely exceeds 80 mmHg , hypertension is virtually nonexistent , and they almost never die from coronary artery disease ....

We need better classifications for ARDS. Definitions must always reflect underlying pathophysiology and, importantly, they should guide our treatment decisions. Unfortunately, the current definitions often fall short in this regard. However, incorporating parameters like extravascular lung water might help bridge that gap. It's also essential to remember that  fluids are drugs —they come with indi...

When he looked at the need for renal replacement therapy , he again found a clear relationship: patients with a positive fluid balance had a higher likelihood of requiring RRT in critical care settings. My name is Djillaili Annane , and I work in Paris at the University of Versailles . This is my fourth time attending the IFAD meeting in Antwerp , where I usually contribute by discussing the role...

I am Niels Van Regenmortel, internist-intensivist and co-organizer of the IFAD meeting from ZNA Stuivenberg in Antwerp, Belgium. participated in the Pro-Con debate on balanced solutions , and I took the "Can" side . My key message was that, while the evidence supporting balanced solutions may not be as definitive as some believe, these fluids are still perfectly safe —and likely better for kidney...

My name is Dr. Sherif Nasr , and I'm from the United States of America . This is our fourth time attending the IFAD meeting —we've only missed one—and it's always a pleasure to be here. I really enjoy the venue , the quality of the program , and the speakers , many of whom I now know personally. Of course, being doctors, our dinner conversations tend to drift into work— two doctors at dinner? Forg...

Let's try not to swing the pendulum too far in the other direction —risking another form of high mortality . Instead, let's aim to find the sweet spot . I am Inneke De laet , Intensivist from ZNA in ANtwerep, Belgium. My lecture focused on  de-resuscitation in the critically ill —and whether this could be the key to solving the problem of fluid overload . As we've seen, aggressive fluid administra...

Before we give fluids, we must first ask the right question: Could this patient potentially benefit from fluid administration? Perhaps they present with hypotension , tachycardia , or oliguria —or maybe a combination of these signs. But never should we give fluids just because "filling" appears low , or because cardiac filling pressures are low , or because echocardiography shows small cardiac cha...

About 1,800 years ago , we had the famous Solvay Conferences , attended by scientific giants like Einstein and Bohr . Today, at this congress, we're privileged to share space with a new generation of international icons of science —contemporary leaders shaping the future of medicine. My name is Dr. Dirk Himpe , and I'm an anesthesiologist at ZiekenhuisNetwerk Antwerpen (ZNA) Middelheim Hospital he...

We're still working in somewhat of an evidence vacuum , but based on the available data , I continue to believe that there are circumstances where colloids remain necessary . Until I see compelling evidence that challenges long-standing clinical practice—practice that has delivered consistently good outcomes and is supported by numerous prospective randomized controlled trials —I won't be convince...

My point is that crystalloids are excellent—when used appropriately . They are especially effective in situations of hypovolemia , low arterial pressure , and low hydrostatic pressure . In these cases, crystalloids can be life-saving. My name is Professor Robert Hahn , and I'm from Stockholm, Sweden . This is my third time attending the IFAD meeting , and it's a pleasure to be here again. In my ta...

We live in a time where we have so many tools and parameters to measure , and we must use this information to decide on the best therapy for our patients. As Professor Lichtenstein points out in his book, there are indeed a multitude of variables , but in the end, it often comes down to just three key choices . My name is Dr. Paul Elbers , and I'm an intensivist at VU University Medical Center in...