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Diagnosing Hypovolemia in Critically Ill Patients

  • A. Perner
  • U. G. Pedersen
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 2010)

Abstract

Hypovolemia is frequent in critically ill patients. There is little doubt that when left unrecognized and thus untreated hypovolemia will worsen patient outcome [1]. Therefore, it is more than likely that adequate fluid resuscitation could improve the outcome of a huge number of critically ill patients worldwide. The administration of fluid is a simple and inexpensive procedure, so one of the barriers for optimal fluid therapy is likely to lie in the diagnosis of hypovolemia.

Keywords

Stroke Volume Fluid Responsiveness Pulse Pressure Variation Stroke Volume Variation Fluid Challenge 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Pinsky MR, Brophy P, Padilla J, Paganini E, Pannu N (2008) Fluid and volume monitoring. Int J Artif Organs 31: 111–126PubMedGoogle Scholar
  2. 2.
    Wiedemann HP, Wheeler AP, Bernard GR, et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354: 2564–2575CrossRefPubMedGoogle Scholar
  3. 3.
    Marik PE, Cavallazzi R, Vasu T, Hirani A (2009) Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med 37: 2642–2647CrossRefPubMedGoogle Scholar
  4. 4.
    Michard F Teboul JL (2002) Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 121: 2000–2008CrossRefPubMedGoogle Scholar
  5. 5.
    Michard F (2005) Changes in arterial pressure during mechanical ventilation. Anesthesiology 103: 419–428CrossRefPubMedGoogle Scholar
  6. 6.
    Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P (1998) Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 89: 1313–1321CrossRefPubMedGoogle Scholar
  7. 7.
    Michard F, Boussat S, Chemla D, et al (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162: 134–138PubMedGoogle Scholar
  8. 8.
    Reuter DA, Felbinger TW, Schmidt C, et al (2002) Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med 28: 392–398CrossRefPubMedGoogle Scholar
  9. 9.
    De Backer D, Heenen S, Piagnerelli M, Koch M, Vincent JL (2005) Pulse pressure variations to predict fluid responsiveness: influence of tidal volume. Intensive Care Med 31: 517–523CrossRefPubMedGoogle Scholar
  10. 10.
    Preisman S, Kogan S, Berkenstadt H, Perel A (2005) Predicting fluid responsiveness in patients undergoing cardiac surgery: functional haemodynamic parameters including the Respiratory Systolic Variation Test and static preload indicators. Br J Anaesth 95: 746–755CrossRefPubMedGoogle Scholar
  11. 11.
    Perner A Faber T (2006) Stroke volume variation does not predict fluid responsiveness in patients with septic shock on pressure support ventilation. Acta Anaesthesiol Scand 50: 1068–1073CrossRefPubMedGoogle Scholar
  12. 12.
    Mahjoub Y, Pila C, Friggeri A, et al (2009) Assessing fluid responsiveness in critically ill patients: False-positive pulse pressure variation is detected by Doppler echocardiographic evaluation of the right ventricle. Crit Care Med 37: 2570–2575CrossRefPubMedGoogle Scholar
  13. 13.
    De Backer D, Taccone FS, Holsten R, Ibrahimi F, Vincent JL (2009) Influence of respiratory rate on stroke volume variation in mechanically ventilated patients. Anesthesiology 110: 1092–1097CrossRefPubMedGoogle Scholar
  14. 14.
    Boulain T, Achard JM, Teboul JL, Richard C, Perrotin D, Ginies G (2002) Changes in BP induced by passive leg raising predict response to fluid loading in critically ill patients. Chest 121: 1245–52CrossRefPubMedGoogle Scholar
  15. 15.
    Monnet X, Rienzo M, Osman D, et al (2006) Passive leg raising predicts fluid responsiveness in the critically ill. Crit Care Med 34: 1402–1407CrossRefPubMedGoogle Scholar
  16. 16.
    Lafanechere A, Pene F, Goulenok C, et al (2006) Changes in aortic blood flow induced by passive leg raising predict fluid responsiveness in critically ill patients. Crit Care 10:R132CrossRefPubMedGoogle Scholar
  17. 17.
    Thiel SW, Kollef MH, Isakow W (2009) Non-invasive stroke volume measurement and passive leg raising predict volume responsiveness in medical ICU patients: an observational cohort study. Crit Care 13: R111CrossRefPubMedGoogle Scholar
  18. 18.
    Lamia B, Ochagavia A, Monnet X, Chemla D, Richard C, Teboul JL (2007) Echocardiographic prediction of volume responsiveness in critically ill patients with spontaneously breathing activity. Intensive Care Med 33: 1125–1132CrossRefPubMedGoogle Scholar
  19. 19.
    Maizel J, Airapetian N, Lorne E, Tribouilloy C, Massy Z, Slama M (2007) Diagnosis of central hypovolemia by using passive leg raising. Intensive Care Med 33: 1133–1138CrossRefPubMedGoogle Scholar
  20. 20.
    De Backer D Pinsky MR (2007) Can one predict fluid responsiveness in spontaneously breathing patients? Intensive Care Med 33: 1111–1113CrossRefPubMedGoogle Scholar
  21. 21.
    De Backer D (2006) Can passive leg raising be used to guide fluid administration? Crit Care 10: 170CrossRefPubMedGoogle Scholar
  22. 22.
    Jabot J, Teboul JL, Richard C, Monnet X (2009) Passive leg raising for predicting fluid responsiveness: importance of the postural change. Intensive Care Med 35: 85–90CrossRefPubMedGoogle Scholar
  23. 23.
    Antonelli M, Levy M, Andrews PJ, et al (2007) Hemodynamic monitoring in shock and implications for management. International Consensus Conference, Paris, France, 27–28 April 2006. Intensive Care Med 33: 575–590CrossRefPubMedGoogle Scholar
  24. 24.
    Bossuyt PM, Reitsma JB, Bruns DE, et al (2003) Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. BMJ 326: 41–44CrossRefPubMedGoogle Scholar
  25. 25.
    Harvey S, Harrison DA, Singer M, et al (2005) Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet 366: 472–477CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • A. Perner
    • 1
  • U. G. Pedersen
    • 1
  1. 1.Department of Intensive CareUniversity Hospital RigshospitaletCopenhagenDenmark

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