This discussion, recorded on day one of EBPOM 2017, a truly international gathering with many countries represented. The Intraoperative hypotension is discussed. New information regarding cognitive function for patients raises big questions. Should shared decision making be re-evaluated? The team then discuss the Perioperative Quality Initiative (POQI) and new information regarding intraoperative hypotension. How rapidly should you attend to fluctuations? What is an appropirate response nowadays? The subject of perioperative nephrology is discussed, including topics such as the fluid challenge, urine output, biomarkers and the timing of renal replacement therapy. Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests Dr Tim Miller from Duke University Medical Centre and John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh. Join in the debate: [email protected]