The subject of my talk was the perioperative management of patients undergoing high-risk surgery. This remains a significant challenge in clinical practice, as a large number of patients require such complex surgical interventions, and the associated complication rates are still considerable. One promising strategy to improve outcomes is the implementation of goal-directed therapy. By closely monitoring and optimizing fluid administration during the perioperative period, we can potentially reduce complications and enhance recovery. However, despite encouraging evidence, several unresolved questions and areas of uncertainty remain regarding this approach. In my talk, I aimed to shed light on these controversies and explore potential pathways for improving patient care in this high-risk population.