Not All Hypotension Is Thirsty: Rethinking Fluids in the OR

In this episode of Anesthesia Alchemy: Lynn & Garry Unplugged, Garry dives deep into the science and strategy behind Goal-Directed Fluid Therapy (GDFT), moving beyond dogma to deliberate, physiology-driven decision-making.

Our guest, Richard Wilson, traces the evolution of perioperative fluid management from liberal “fill-the-tank” approaches to modern, data-informed strategies that respect the Frank–Starling relationship and the nuanced concept of fluid responsiveness. Along the way, they unpack essential hemodynamic variables—stroke volume, cardiac output, preload, afterload, and contractility explaining why hypotension or low output doesn’t always mean the patient needs more fluid.

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