Basic concepts of fluid responsiveness |
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Authors: | T G V Cherpanath B F Geerts W K Lagrand M J Schultz A B J Groeneveld |
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Institution: | 1. Department of Intensive Care Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands 2. Department of Intensive Care Medicine, Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands 3. Department of Intensive Care Medicine, Erasmus Medical Centre, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands
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Abstract: | Predicting fluid responsiveness, the response of stroke volume to fluid loading, is a relatively novel concept that aims to optimise circulation, and as such organ perfusion, while avoiding futile and potentially deleterious fluid administrations in critically ill patients. Dynamic parameters have shown to be superior in predicting the response to fluid loading compared with static cardiac filling pressures. However, in routine clinical practice the conditions necessary for dynamic parameters to predict fluid responsiveness are frequently not met. Passive leg raising as a means to alter biventricular preload in combination with subsequent measurement of the change in stroke volume can provide a fast and accurate way to guide fluid management in a broad population of critically ill patients. |
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Keywords: | Fluid responsiveness Venous return Cardiac function Pulse contour analysis Passive leg raising |
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