Assessing fluid responsiveness by stroke volume variation in mechanically ventilated patients with severe sepsis

Marx, Gernot; Cope, T.; McCrossan, L.; Swaraj, S; Cowan, Chris; Mostafa, S.M.; Wenstone, Richard; Leuwer, Martin

doi:10.1017/s0265021504002091

Cited by 91 publications

(48 citation statements)

References 26 publications

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“…The characteristics of these studies were summarized in Table 1. Fourteen studies [22, 23, 25-28, 31, 34, 36, 38-41, 44] were performed in the operating room (OR) under general anesthesia, and 8 [24,29,30,32,33,35,42,43] were performed in the intensive care unit (ICU). Patients in the latter setting were heterogeneous, including those after cardiac surgery, with severe sepsis and acute respiratory failure.…”

Section: Searching Results and Study Characteristicsmentioning

confidence: 99%

Accuracy of stroke volume variation in predicting fluid responsiveness: a systematic review and meta-analysis

et al. 2011

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Section: Searching Results and Study Characteristicsmentioning

confidence: 99%

Accuracy of stroke volume variation in predicting fluid responsiveness: a systematic review and meta-analysis

et al. 2011

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“…It means that if the left ventricular pressure (and CO) is dependent on fluid, during inspiration, a period of reduced blood flow during positive pressure ventilation, the right ventricular pressure will interfere with the left ventricular volume, thus reducing the CO in this period. Several parameters have been established, such as systolic volume variation, but also echocardiographic parameters: pulsed Doppler variation at the left ventricular outflow tract, and inferior vena cava variation [37][38][39] . Yet the most relevant observed fact is that no static parameter for fluid evaluation (CVP or Pw) is capable of distinguishing the patients who can benefit from fluid infusion [40] .…”

Section: Monitoring Devicesmentioning

confidence: 99%

Diagnostic tools and therapeutic end-points in critical care medicine: Limitations and concepts

Severino

Marum²,

Marcelino

2014

JNEP

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In Intensive Care Medicine (ICM) the presence of multiple high tech devices is common in order to perform multiple medical and non-medical procedures. The authors intend to perform a critical appraisal on the basic and practical/clinical approach to monitoring devices, analyzing the evidence support regarding clinical effects, end-points, and patient safety. All data that provides a diagnosis or a characterization of the patient's status will be considered diagnostic information whereas, variables that could be achieved by medical interventions will be considered therapeutic end-points. In any healthcare setting a careful approach to the patient is needed, namely in ICM one must consider the patient's clinical condition and choose adequate diagnostic tools and devices. Not all variables and devices currently on the market are suitable for each patient, nor proved useful in the setting under study. Also, all patients are different and must be approached differently according to established clinical end-points, translating into more holistic caregiving. ICM requires a personalized approach towards the patient, consequently, submitting diagnostic tools and monitoring devices to greater scrutiny in order to obtain greater patient benefit.

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“…Veränderungen des ZVD oder PAOP korrelieren überhaupt nicht mit Veränderungen des HZV und sind somit als Indikator einer Vorlastabhängigkeit unbrauchbar. Aus diesem Grund werden in den letzten Jahren zunehmend dynamische Messverfahren wie die Schlagvolumenvariation [72], die systolische Druckvariation [73] oder die arterielle Pulsdruckvariation eingesetzt, die v. a. bei beatmeten Patienten den Einfluss der wechselnden intrathorakalen Drücke bei Inspiration und Exspiration auf die kardiale Vor-bzw. Nachlast nutzen, um eine Vorlastabhängigkeit des Ventrikels sichtbar und messbar zu machen.…”

Section: Vorlast Und Nachlastunclassified

Akute Herzinsuffizienz

Janssens

2012

Med Klin Intensivmed Notfmed

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Acute decompensated heart failure (ADHF) is a major public health problem throughout the world and its importance is continuing to grow. More than 50% of ADHF patients have coronary artery disease, which is generally associated with a history of hypertension. Recent data suggest that half of the patients presenting with acute heart failure have preserved left ventricular systolic function. The diagnosis of ADHF may be difficult at times, and the clinical assessment and patient profiling is essential for appropriate therapy. Immediate therapeutic goals are not only to improve symptoms, restore oxygenation and stabilize hemodynamic conditions, but also to improve short- and long-term survival. In addition to general supportive measures such as oxygen supplementation, noninvasive ventilation, analgesia, diuretics, vasodilators together with inotropic agents and/or vasopressors remain the cornerstone of therapy in patients with ADHF.

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Assessing fluid responsiveness by stroke volume variation in mechanically ventilated patients with severe sepsis

Abstract: Measuring stroke volume variation may be a useful way of guiding fluid therapy in ventilated patients with severe sepsis because it allows estimation of preload and prediction of cardiac index changes in response to fluid loading.

Cited by 91 publications

References 26 publications

Accuracy of stroke volume variation in predicting fluid responsiveness: a systematic review and meta-analysis

Accuracy of stroke volume variation in predicting fluid responsiveness: a systematic review and meta-analysis

Diagnostic tools and therapeutic end-points in critical care medicine: Limitations and concepts

Akute Herzinsuffizienz

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