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Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review
In patients with acute circulatory failure, fluid administration represents a first-line therapeutic intervention for improving cardiac output. However, only approximately 50% of patients respond to fluid infusion with a significant increase in cardiac output, defined as fluid responsiveness. Additi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871108/ https://www.ncbi.nlm.nih.gov/pubmed/35204603 http://dx.doi.org/10.3390/diagnostics12020513 |
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author | Horejsek, Jan Kunstyr, Jan Michalek, Pavel Porizka, Michal |
author_facet | Horejsek, Jan Kunstyr, Jan Michalek, Pavel Porizka, Michal |
author_sort | Horejsek, Jan |
collection | PubMed |
description | In patients with acute circulatory failure, fluid administration represents a first-line therapeutic intervention for improving cardiac output. However, only approximately 50% of patients respond to fluid infusion with a significant increase in cardiac output, defined as fluid responsiveness. Additionally, excessive volume expansion and associated hyperhydration have been shown to increase morbidity and mortality in critically ill patients. Thus, except for cases of obvious hypovolaemia, fluid responsiveness should be routinely tested prior to fluid administration. Static markers of cardiac preload, such as central venous pressure or pulmonary artery wedge pressure, have been shown to be poor predictors of fluid responsiveness despite their widespread use to guide fluid therapy. Dynamic tests including parameters of aortic blood flow or respiratory variability of inferior vena cava diameter provide much higher diagnostic accuracy. Nevertheless, they are also burdened with several significant limitations, reducing the reliability, or even precluding their use in many clinical scenarios. This non-systematic narrative review aims to provide an update on the novel, less employed dynamic tests of fluid responsiveness evaluation in critically ill patients. |
format | Online Article Text |
id | pubmed-8871108 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88711082022-02-25 Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review Horejsek, Jan Kunstyr, Jan Michalek, Pavel Porizka, Michal Diagnostics (Basel) Review In patients with acute circulatory failure, fluid administration represents a first-line therapeutic intervention for improving cardiac output. However, only approximately 50% of patients respond to fluid infusion with a significant increase in cardiac output, defined as fluid responsiveness. Additionally, excessive volume expansion and associated hyperhydration have been shown to increase morbidity and mortality in critically ill patients. Thus, except for cases of obvious hypovolaemia, fluid responsiveness should be routinely tested prior to fluid administration. Static markers of cardiac preload, such as central venous pressure or pulmonary artery wedge pressure, have been shown to be poor predictors of fluid responsiveness despite their widespread use to guide fluid therapy. Dynamic tests including parameters of aortic blood flow or respiratory variability of inferior vena cava diameter provide much higher diagnostic accuracy. Nevertheless, they are also burdened with several significant limitations, reducing the reliability, or even precluding their use in many clinical scenarios. This non-systematic narrative review aims to provide an update on the novel, less employed dynamic tests of fluid responsiveness evaluation in critically ill patients. MDPI 2022-02-16 /pmc/articles/PMC8871108/ /pubmed/35204603 http://dx.doi.org/10.3390/diagnostics12020513 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Horejsek, Jan Kunstyr, Jan Michalek, Pavel Porizka, Michal Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review |
title | Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review |
title_full | Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review |
title_fullStr | Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review |
title_full_unstemmed | Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review |
title_short | Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review |
title_sort | novel methods for predicting fluid responsiveness in critically ill patients—a narrative review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871108/ https://www.ncbi.nlm.nih.gov/pubmed/35204603 http://dx.doi.org/10.3390/diagnostics12020513 |
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