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Chapter 11 - Assessing Intravascular Volume Status and Fluid Responsiveness: A Non-Ultrasound Approach

Published online by Cambridge University Press:  28 April 2020

By
David S. Beebe
Edited by
Andrew B. Leibowitz  and
Suzan Uysal
Andrew B. Leibowitz
Affiliation:
Icahn School of Medicine at Mount Sinai
Suzan Uysal
Affiliation:
Icahn School of Medicine at Mount Sinai
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Summary

Estimation of intravascular volume status by clinical examination and static measurements such as central venous pressure and pulmonary capillary wedge pressure do not predict fluid responsiveness. Current evidence indicates that dynamic monitoring of arterial pressure and derived indices are the most sensitive and specific means of determining fluid responsiveness, especially in mechanically ventilated patients. Several monitors that automate and embellish this approach, a few of which are noninvasive, are now commercially available and they are gradually being incorporated into intensive and perioperative care practice. This chapter reviews the physiologic underpinnings of how and why the arterial pressure waveform can be used to determine fluid responsiveness and gives an overview of the devices incorporating these principles.

Keywords

Intravascular volumefluid responsivenesspulse pressure variationstroke volume variationperfusion indexplethysmographypleth variability indexgoal-directed therapy
Type
Chapter
Information
Modern Monitoring in Anesthesiology and Perioperative Care , pp. 109 - 116
Publisher: Cambridge University Press
Print publication year: 2020

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