Echocardiographic Assessment of Preload Responsiveness in Critically Ill Patients | Zendy

Alexander Levitov | Zendy; Paul E. Marik | Zendy

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Echocardiographic Assessment of Preload Responsiveness in Critically Ill Patients

Author(s) -

Alexander Levitov,

Paul E. Marik

Publication year - 2011

Publication title -

cardiology research and practice

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.437

H-Index - 35

eISSN - 2090-8016

pISSN - 2090-0597

DOI - 10.1155/2012/819696

Subject(s) - preload , medicine , intravascular volume status , critically ill , resuscitation , central venous pressure , intensive care medicine , cardiac output , intravenous fluid , mechanical ventilation , ventilation (architecture) , cardiology , hemodynamics , blood pressure , anesthesia , heart rate , mechanical engineering , engineering

Fluid challenges are considered the cornerstone of resuscitation in critically ill patients. However, clinical studies have demonstrated that only about 50% of hemodynamically unstable patients are volume responsive. Furthermore, increasing evidence suggests that excess fluid resuscitation is associated with increased mortality. It therefore becomes vital to assess a patient's fluid responsiveness prior to embarking on fluid loading. Static pressure (CVP, PAOP) and echocardiographic (IVC diameter, LVEDA) parameters fails to predict volume responsiveness. However, a number of dynamic echocardiographic parameters which are based on changes in vena-caval dimensions or cardiac function induce by positive pressure ventilation or passive leg raising appear to be highly predictive of volume responsiveness.

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