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Hemodynamic parameters to guide fluid therapy

Paul E Marik, Xavier Monnet, Jean-Louis Teboul

Annals of Intensive Care · 2011 · Review · CC BY-NC-ND

doi:10.1186/2110-5820-1-1

Abstract

The clinical determination of the intravascular volume can be extremely difficult in critically ill and injured patients as well as those undergoing major surgery. This is problematic because fluid loading is considered the first step in the resuscitation of hemodynamically unstable patients. Yet, multiple studies have demonstrated that only approximately 50% of hemodynamically unstable patients in the intensive care unit and operating room respond to a fluid challenge. Whereas under-resuscitation results in inadequate organ perfusion, accumulating data suggest that over-resuscitation increases the morbidity and mortality of critically ill patients. Cardiac filling pressures, including the central venous pressure and pulmonary artery occlusion pressure, have been traditionally used to guide fluid management. However, studies performed during the past 30 years have demonstrated that cardiac filling pressures are unable to predict fluid responsiveness. During the past decade, a number of dynamic tests of volume responsiveness have been reported. These tests dynamically monitor the change in stroke volume after a maneuver that increases or decreases venous return (preload) and challenges the patients' Frank-Starling curve. These dynamic tests use the change in stroke volume during mechanical ventilation or after a passive leg raising maneuver to assess fluid responsiveness. The stroke volume is measured continuously and in real-time by minimally invasive or noninvasive technologies, including Doppler methods, pulse contour analysis, and bioreactance.

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References 59

  1. 1.

    Levy MM Macias WL Russell JA Williams MD Trzaskoma BL Silva E Vincent JL Failure to improve during the first day of therapy is predictive of 28-day mortality in severe sepsisChest2004 124Suppl120 S

    Not in our library

  2. 2.

    Rivers E Nguyen B Havstad S Ressler J Muzzin A Knoblich B Peterson E Tomlanovich M Early goal-directed therapy in the treatment of severe sepsis and septic shockN Engl J Med2001 34513681377

    Not in our library10.1056/nejmoa010307

  3. 3.
  4. 4.

    Murakawa K Kobayashi A Effects of vasopressors on renal tissue gas tensions during hemorrhagic shock in dogsCrit Care Med1988 16789792

    Not in our library10.1097/00003246-198808000-00012

  5. 5.

    Rosenberg AL Dechert RE Park PK Bartlett RH Review of a large clinical series: association of cumulative fluid balance on outcome in acute lung injury: a retrospective review of the ARDSnet tidal volume study cohortJ Intensive Care Med2009 243546

    Not in our library10.1177/0885066608329850

  6. 6.

    Murphy CV Schramm GE Doherty JA Reichley RM Gajic O Afessa B Micek ST Kollef MH The importance of fluid management in acute lung injury secondary to septic shockChest2009 136102109

    Not in our library10.1378/chest.08-2706

  7. 7.

    Boyd JH Forbes J Nakada T Walley KR Russell JA Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure increase mortalityCrit Care Med2010 in press

    Not in our library10.1097/ccm.0b013e3181feeb15

  8. 8.

    Tagami T Kushimoto S Yamamoto Y Atsumi T Tosa R Matsuda K Oyama R Kawaguchi T Masuno T Hirama H Yokota H Validation of extravascular lung water measurement by single transpulmonary thermodilution: human autopsy studyCrit Care2010 14R162

    Not in our library10.1186/cc9250

  9. 9.

    Fernandez-Mondejar E Rivera-Fernandez R Garcia-Delgado M Touma A Machado J Chavero J Small increases in extravascular lung water are accurately detected by transpulmonary thermodilutionJ Trauma2005 5914201423

    Not in our library10.1097/01.ta.0000198360.01080.42

  10. 10.

    Monnet X Anguel N Osman D Hamzaoui O Richard C Teboul JL Assessing pulmonary permeability by transpulmonary thermodilution allows differentiation of hydrostatic pulmonary edema from ALI/ARDSIntensive Care Med2007 33448453

    Not in our library10.1007/s00134-006-0498-6

  11. 11.

    Sakka SG Klein M Reinhart K Meier-Hellmann A Prognostic value of extravascular lung water in critically ill patientsChest2002 12220802086

    Not in our library10.1378/chest.122.6.2080

  12. 12.

    Chung FT Lin SM Lin SY Lin HC Impact of extravascular lung water index on outcomes of severe sepsis patients in a medical intensive care unitRespir Med2008 102956961

    Not in our library10.1016/j.rmed.2008.02.016

  13. 13.

    Hayes MA Timmins AC Yau E Palazzo M Hinds CJ Watson D Elevation of systemic oxygen delivery in the treatment of critically ill patientsN Engl J Med1994 33017171722

    Not in our library10.1056/nejm199406163302404

  14. 14.

    Gattinoni L Brazzi L Pelosi P Latini R Tognoni G Pesenti A A trial of goal-oriented hemodynamic therapy in critically ill patientsN Engl J Med1995 33310251032

    Not in our library10.1056/nejm199510193331601

  15. 15.

    Marik PE Cavallazzi R Vasu T Hirani A Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients. A systematic review of the literatureCrit Care Med2009 3726422647

    Not in our library10.1097/ccm.0b013e3181a590da

  16. 16.

    Braunwald E Sonnenblick EH Ross J Braunwald EMechanisms of cardiac contraction and relaxationHeart Disease1988 Philadelphia: WB Saunders383425

    Not in our library

  17. 17.

    Nixon JV Murray RG Leonard PD Mitchell JH Blomqvist CG Effect of large variations in preload on left ventricular characteristics in normal subjectsCirculation1982 65698703

    Not in our library10.1161/01.cir.65.4.698

  18. 18.

    Kastrup M Markewitz A Spies C Carl M Erb J Grosse J Schirmer U Current practice of hemodynamic monitoring and vasopressor and inotropic therapy in post-operative cardiac surgery patients in Germany: results from a postal surveyActa Anaesthesiol Scand2007 51347358

    Not in our library10.1111/j.1399-6576.2006.01190.x

  19. 19.

    McIntyre LA Hebert PC Fergusson D Cook DJ Aziz A A survey of Canadian intensivists' resuscitation practices in early septic shockCrit Care2007 11R74

    Not in our library10.1186/cc5962

  20. 20.

    Weil MH Henning RJ New concepts in the diagnosis and fluid treatment of circulatory shock. Thirteenth annual Becton, Dickinson and Company Oscar Schwidetsky Memorial LectureAnesth Analg1979 58124132

    Not in our library10.1213/00000539-197903000-00013

  21. 21.

    Marik PE Baram M Vahid B Does the central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven maresChest2008 134172178

    Not in our library10.1378/chest.07-2331

  22. 22.

    Nolen-Walston RD Norton JL de Solis C Underwood C Boston R Slack J Dallap BL The effects of hypohydration on central venous pressure and splenic volume in adult horsesJ Vet Intern Med2010

    Not in our library10.1111/j.1939-1676.2010.0641.x

  23. 23.

    Magdesian KG Fielding CL Rhodes DM Ruby RE Changes in central venous pressure and blood lactate concentration in response to acute blood loss in horsesJ Am Vet Med Assoc2006 22914581462

    Not in our library10.2460/javma.229.9.1458

  24. 24.

    Michard F Teboul JL Using heart-lung interactions to assess fluid responsiveness during mechanical ventilationCrit Care2000 4282289

    Not in our library10.1186/cc710

  25. 25.

    Theres H Binkau J Laule M Heinze R Hundertmark J Blobner M Erhardt W Baumann G Stangl K Phase-related changes in right ventricular cardiac output under volume-controlled mechanical ventilation with positive end-expiratory pressureCrit Care Med1999 27953958

    Not in our library10.1097/00003246-199905000-00033

  26. 26.

    Desebbe O Cannesson M Using ventilation-induced plethysmographic variations to optimize patient fluid statusCurr Opin Anaesthesiol2008 21772778

    Not in our library10.1097/aco.0b013e32831504ca

  27. 27.

    Natalini G Rosano A Taranto M Faggian B Vittorielli E Bernaardini A Arterial versus plethysmographic dynamic indices to test responsiveness for testing fluid administration in hypotensive patients: a clinical trialAnesth Analg2006 10314781484

    Not in our library10.1213/01.ane.0000246811.88524.75

  28. 28.

    Cannesson M Besnard C Durand PG Bohe J Jacques D Relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and arterial pulse pressure in ventilated patientsCrit Care2005 9R562R568

    Not in our library10.1186/cc3799

  29. 29.

    Feissel M Teboul JL Merlani P Badie J Faller JP Bendjelid K Plethysmographic dynamic indices predict fluid responsiveness in septic ventilated patientsIntensive Care Med2007 33993999

    Not in our library10.1007/s00134-007-0602-6

  30. 30.

    Cannesson M Desebbe O Rosamel P Delannoy B Robin J Bastien O Lehot JJ Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatreBr J Anaesth2008 101200206

    Not in our library10.1093/bja/aen133

  31. 31.

    Cannesson M Delannoy B Morand A Rosamel P Attof Y Bastien O Lehot JJ Does the Pleth variability index indicate the respiratory-induced variation in the plethysmogram and arterial pressure waveforms?Anesth Analg2008 10611891194

    Not in our library10.1213/ane.0b013e318167ab1f

  32. 32.

    Reuter DA Bayerlein J Goepfert MS Weis FC Kilger E Lamm P Goetz AE Influence of tidal volume on left ventricular stroke volume variation measured by pulse contour analysis in mechanically ventilated patientsIntensive Care Med2003 29476480

    Not in our library10.1007/s00134-003-1649-7

  33. 33.

    De Backer D Heenen S Piagnerelli M Koch M Vincent JL Pulse pressure variations to predict fluid responsiveness: influence of tidal volumeIntensive Care Med2005 31517523

    Not in our library10.1007/s00134-005-2586-4

  34. 34.

    Feissel M Michard F Mangin I Ruyer O Faller JP Teboul JL Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shockChest2001 119867873

    Not in our library10.1378/chest.119.3.867

  35. 35.

    Monnet X Rienzo M Osman D Anguel N Richard C Pinsky MR Teboul JL Esophageal Doppler monitoring predicts fluid responsiveness in critically ill ventilated patientsIntensive Care Med2005 3111951201

    Not in our library10.1007/s00134-005-2731-0

  36. 36.

    Barbier C Loubieres Y Schmit C Hayon J Ricome JL Jardin F Vieillard-Baron A Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patientsIntensive Care Med2004 3017401746

    Not in our library10.1007/s00134-004-2259-8

  37. 37.

    Feissel M Michard F Faller JP Teboul JL The respiratory variation in inferior vena cava diameter as a guide to fluid therapyIntensive Care Med2004 3018341837

    Not in our library10.1007/s00134-004-2233-5

  38. 38.

    Vieillard-Baron A Augarde R Prin S Page B Beauchet A Jardin F Influence of superior vena caval zone condition on cyclic changes in right ventricular outflow during respiratory supportAnesthesiol2001 9510831088

    Not in our library10.1097/00000542-200111000-00010

  39. 39.

    Vieillard-Baron A Chergui K Rabiller A Peyrouset O Page B Beauchet A Jardin F Superior vena caval collapsibility as a gauge of volume status in ventilated septic patientsIntensive Care Med2004 3017341739

    Not in our library10.1007/s00134-004-2361-y

  40. 40.

    Monnet X Osman D Ridel C Lamia B Richard C Teboul JL Predicting volume responsiveness by using the end-expiratory occlusion in mechanically ventilated intensive care unit patientsCrit Care Med2009 37951956

    Not in our library10.1097/ccm.0b013e3181968fe1

All 59 references

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