Continuous veno-venous hemofiltration to adjust fluid volume excess in septic shock patients reduces intra-abdominal pressure

Dąbrowski, Wojciech; Kotlińska-Hasiec, Edyta; Schneditz, Daniel; Załuska, Wojciech; Rzecki, Ziemowit; Keulenaer, Bart De; Malbrain, Manu L N G

doi:10.5414/cn108015

Cited by 21 publications

(27 citation statements)

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“…De laet et al demonstrated similarly that RRT with a mean net fluid loss of 1.9 L in a total of 25 dialysis sessions decreased IAP from 12 to 11 mm Hg (P < 0.0001) [35]. Finally, Dabrowski et al recently concluded that continuous RRT to reduce fluid overload in patients with septic shock and acute kidney injury reduces IAP [36].…”

Section: Place For Furosemide Infusion or Renal Replacement Therapymentioning

confidence: 89%

“…This relationship has been demonstrated for critically ill surgical patients [68], mixed medical and surgical patients [69], and in patients with septic shock [36,70], severe acute pancreatitis [71], acute respiratory failure [19], and ruptured abdominal aortic aneurysms [66].…”

Section: Abdominal Perfusion Pressurementioning

confidence: 99%

“…This pathology may increase extravascular water content in the limbs disturbing bioimpedance reliability. Dabrowski et al found a strong correlation between IAP and fluid overload, which was measured using whole-body bioimpedance [36]. A lack of reduction in total body and extravascular water was associated with poor outcome.…”

Section: How To Assess Fluid Balance In Patients With Iah?mentioning

confidence: 99%

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Fluid therapy and perfusional considerations during resuscitation in critically ill patients with intra-abdominal hypertension

Regli

Keulenaer²,

Laet³

et al. 2014

Anaesthesiol Intensive Ther

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Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are consistently associated with morbidity and mortality among the critically ill or injured. Thus, avoiding or potentially treating these conditions may improve patient outcomes. With the aim of improving the outcomes for patients with IAH/ACS, the World Society of the Abdominal Compartment Syndrome recently updated its clinical practice guidelines. In this article, we review the association between a positive fluid balance and outcomes among patients with IAH/ACS and how optimisation of fluid administration and systemic/regional perfusion may potentially lead to improved outcomes among this patient population. Evidence consistently associates secondary IAH with a positive fluid balance. However, despite increased research in the area of non-surgical management of patients with IAH and ACS, evidence supporting this approach is limited. Some evidence exists to support implementing goal-directed resuscitation protocols and restrictive fluid therapy protocols in shocked and recovering critically ill patients with IAH. Data from animal experiments and clinical trials has shown that the early use of vasopressors and inotropic agents is likely to be safe and may help reduce excessive fluid administration, especially in patients with IAH. Studies using furosemide and/or renal replacement therapy to achieve a negative fluid balance in patients with IAH are encouraging. The type of fluid to be administered in patients with IAH remains far from resolved. There is currently insufficient evidence to recommend the use of abdominal perfusion pressure as a resuscitation endpoint in patients with IAH. However, it is important to recognise that IAH either abolishes or increases threshold values for pulse pressure variation and stroke volume variation to predict fluid responsiveness, while the presence of IAH may also result in a false negative passive leg raising test. Correct fluid therapy and perfusional support during resuscitation form the cornerstone of medical management in patients with abdominal hypertension. Controlled studies determining whether the above medical interventions may improve outcomes among those with IAH/ACS are urgently required.

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Section: Place For Furosemide Infusion or Renal Replacement Therapymentioning

confidence: 89%

Section: Abdominal Perfusion Pressurementioning

confidence: 99%

Section: How To Assess Fluid Balance In Patients With Iah?mentioning

confidence: 99%

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Fluid therapy and perfusional considerations during resuscitation in critically ill patients with intra-abdominal hypertension

Regli

Keulenaer²,

Laet³

et al. 2014

Anaesthesiol Intensive Ther

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“…Máttar et al compared raw parameters from SF‐BIA in septic and nonseptic patients with healthy controls in an adult Brazilian population and found that capacitance and phase angle at 50 kHz declined in proportion to severity of illness . Dabrowski et al, using TBW trends gathered with BIS (Xitron Hydra 4200 and accompanying software), ECW, and ECW/ICW in 37 patients undergoing continuous veno–venous hemofiltration, found a sustained increase in these parameters among nonsurvivors …”

Section: Different Modalities For Body Composition Assessmentmentioning

confidence: 99%

Body Composition Technology: Implications for the ICU

2018

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Malnutrition continues to be highly prevalent in hospitalized and critically ill patients and is associated with significant morbidity and mortality. Additionally, survivors of critical illness have an increased risk for sarcopenia, which leads to weakness and physical debilitation that can persist for years. Nutrition risk assessment tools have been developed and validated in critically ill patients but have limitations. Variables such as body weight, body mass index, weight change, or percentage of food intake can be difficult to obtain in critically ill patients and may be misleading given changes in body composition, such as an increase in body water. Assessment of body composition through new techniques provides a unique opportunity to counter some of these limitations and develop improved methods of nutrition risk assessment based on objective data. The present manuscript provides a review of the most commonly available clinical technology for assessment of body composition (bioimpedance, computed tomography, and ultrasound), including data from trials in critically ill patients highlighting the benefits and weaknesses of each modality.

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“…1,2 Bioimpedance is considered to be a sensitive tool for measuring body fluid composition; however, the interpretation of this data is difficult. The raw impedance data, consisting of resistance and reactance values, are abstract, and provide only indirect information on extraand intracellular fluid volumes.…”

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confidence: 99%

The effect of crystalloid infusion on body water content and intra-abdominal pressure in patients undergoing orthopedic surgery under spinal anesthesia

Kotlińska-Hasiec¹,

Rutyna²,

Rzecki³

et al. 2017

Adv Clin Exp Med

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Continuous veno-venous hemofiltration to adjust fluid volume excess in septic shock patients reduces intra-abdominal pressure

Cited by 21 publications

References 0 publications

Fluid therapy and perfusional considerations during resuscitation in critically ill patients with intra-abdominal hypertension

Fluid therapy and perfusional considerations during resuscitation in critically ill patients with intra-abdominal hypertension

Body Composition Technology: Implications for the ICU

The effect of crystalloid infusion on body water content and intra-abdominal pressure in patients undergoing orthopedic surgery under spinal anesthesia

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