[Fluid management: estimation of fluid status].
Cardiac filling pressures alone are not appropriate to estimate the effect of a volume challenge on the corresponding change in stroke volume. Dynamic variables of fluid responsiveness have been shown to discriminate with acceptable sensitivity and specificity between responders and non-responders to a volume challenge. However, several clinical confounders have been indentified which potentially influence the predictive power of these variables. Sound knowledge of these confounders and the acknowledgement that there is no unique threshold value for volume optimisation but a considerable "gray zone" is necessary to fully exploit the advantages of functional haemodynamic monitoring.
Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel. Seine Schwerpunkte sind das hämodynamische Monitoring und die Kardioanästhesie (Erwachsene und Pädiatrie). jochen.renner@uksh.de
Jochen
J
Renner
Ole
O
Broch
Berthold
B
Bein
D001794:Blood Pressure / Q000502:physiology; D002496:Central Venous Pressure; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016343:Monitoring, Intraoperative; D019990:Perioperative Care / Q000379:methods*; D013318:Stroke Volume / Q000502:physiology