Con: we should fully utilise the preload reserve in high-risk patients undergoing noncardiac surgery

Even in fluid-responsive patients, the indication for fluids should be determined individually from haemodynamics and clinical context; fluid responsiveness is a normal physiological state and does not necessarily mean fluids are needed

Clinicians should not routinely try to maximise stroke volume or CO with fluids during surgery, since surgical patients are unlikely to need maximal CO (energy expenditure under major surgery with GA roughly one quarter lower than resting awake)

Clinicians should not routinely give repeated fluid boluses simply to use the full preload reserve in major noncardiac surgery

Fluid decisions must incorporate considerations far beyond fluid responsiveness