Swipe om te navigeren naar een ander artikel
Predicting fluid responsiveness, the response of stroke volume to fluid loading, is a relatively novel concept that aims to optimise circulation, and as such organ perfusion, while avoiding futile and potentially deleterious fluid administrations in critically ill patients. Dynamic parameters have shown to be superior in predicting the response to fluid loading compared with static cardiac filling pressures. However, in routine clinical practice the conditions necessary for dynamic parameters to predict fluid responsiveness are frequently not met. Passive leg raising as a means to alter biventricular preload in combination with subsequent measurement of the change in stroke volume can provide a fast and accurate way to guide fluid management in a broad population of critically ill patients.
Guyton AC, Lindsey AW, Abernathy B, et al. Mechanism of the increased venous return and cardiac output caused by epinephrine. Am J Physiol. 1958;192:126–30. PubMed
Guyton AC. Determination of cardiac output by equating venous return curves with cardiac response curves. Physiol Rev. 1955;35:123–9. PubMed
Geerts BF, Maas JJ, de Wilde RBP, et al. Hemodynamic assessment in the Dutch intensive care unit. Neth J Crit Care. 2009;13:178–84. CrossRef
Braunwald E, Sonnenblick EH, Ross J. Mechanisms of cardiac contraction and relaxation. In: Braunwald E, editor. Heart disease. Philadelphia: Saunders; 1998. p. 389–425.
Marx G, Cope T, McCrossan L, et al. Assessing fluid responsiveness by stroke volume variation in mechanically ventilated patients with severe sepsis. Eur J Anaesthesiol. 2004;21:132–8. PubMed
Reuter DA, Bayerlein J, Goepfert MS, et al. Influence of tidal volume on left ventricular stroke volume variation measured by pulse contour analysis in mechanically ventilated patients. Intensive Care Med. 2003;29:476–80. PubMed
Vieillard-Baron A, Chergui K, Rabiller A, et al. Superior vena caval collapsibility as a gauge of volume status in ventilated septic patients. Intensive Care Med. 2004;30:1734–9. PubMed
- Basic concepts of fluid responsiveness
T. G. V. Cherpanath
B. F. Geerts
W. K. Lagrand
M. J. Schultz
A. B. J. Groeneveld
- Bohn Stafleu van Loghum