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How can assessing h...
How can assessing hemodynamics help to assess volume status?
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- De Backer, Daniel (författare)
- Univ Libre Bruxelles, Belgium
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- Aissaoui, Nadia (författare)
- Univ Paris, France; INSERM, France
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- Cecconi, Maurizio (författare)
- Humanitas Clin & Res Ctr IRCCS, Italy; Humanitas Univ, Italy
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- Chew, Michelle S, 1969- (författare)
- Linköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US
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- Denault, Andre (författare)
- Univ Montreal, Canada; Univ Montreal, Canada
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- Hajjar, Ludhmila (författare)
- Univ Sao Paulo, Brazil
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- Hernandez, Glenn (författare)
- Pontificia Univ Catolica Chile, Chile
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- Messina, Antonio (författare)
- Humanitas Clin & Res Ctr IRCCS, Italy; Humanitas Univ, Italy
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- Myatra, Sheila Nainan (författare)
- Tata Mem Hosp, India
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- Ostermann, Marlies (författare)
- Kings Coll London, England
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- Pinsky, Michael R. (författare)
- Univ Pittsburgh, PA USA
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- Teboul, Jean-Louis (författare)
- Univ Paris Saclay, France
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- Vignon, Philippe (författare)
- Dupuytren Teaching Hosp, France; Dupuytren Teaching Hosp, France
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- Vincent, Jean-Louis (författare)
- Univ Libre Bruxelles, Belgium
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- Monnet, Xavier (författare)
- Univ Paris Saclay, France
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(creator_code:org_t)
- 2022-08-10
- 2022
- Engelska.
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Ingår i: Intensive Care Medicine. - : SPRINGER. - 0342-4642 .- 1432-1238. ; 48, s. 11482-1494
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- In critically ill patients, fluid infusion is aimed at increasing cardiac output and tissue perfusion. However, it may contribute to fluid overload which may be harmful. Thus, volume status, risks and potential efficacy of fluid administration and/or removal should be carefully evaluated, and monitoring techniques help for this purpose. Central venous pressure is a marker of right ventricular preload. Very low values indicate hypovolemia, while extremely high values suggest fluid harmfulness. The pulmonary artery catheter enables a comprehensive assessment of the hemodynamic profile and is particularly useful for indicating the risk of pulmonary oedema through the pulmonary artery occlusion pressure. Besides cardiac output and preload, transpulmonary thermodilution measures extravascular lung water, which reflects the extent of lung flooding and assesses the risk of fluid infusion. Echocardiography estimates the volume status through intravascular volumes and pressures. Finally, lung ultrasound estimates lung edema. Guided by these variables, the decision to infuse fluid should first consider specific triggers, such as signs of tissue hypoperfusion. Second, benefits and risks of fluid infusion should be weighted. Thereafter, fluid responsiveness should be assessed. Monitoring techniques help for this purpose, especially by providing real time and precise measurements of cardiac output. When decided, fluid resuscitation should be performed through fluid challenges, the effects of which should be assessed through critical endpoints including cardiac output. This comprehensive evaluation of the risk, benefits and efficacy of fluid infusion helps to individualize fluid management, which should be preferred over a fixed restrictive or liberal strategy.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Cardiac output; Tissue perfusion; Hypovolemia; Hypervolemia; Extravascular lung water; Tissue edema
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De Backer, Danie ...
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Aissaoui, Nadia
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Cecconi, Maurizi ...
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Chew, Michelle S ...
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Denault, Andre
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Hajjar, Ludhmila
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Hernandez, Glenn
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Messina, Antonio
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Myatra, Sheila N ...
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Ostermann, Marli ...
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Pinsky, Michael ...
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Teboul, Jean-Lou ...
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Vignon, Philippe
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Vincent, Jean-Lo ...
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Monnet, Xavier
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