title: Assessment of volume status and fluid responsiveness in the emergency department: a systematic approach.
abstract: When treating acutely ill patients in the emergency department (ED), the successful management of a variety of medical conditions, such as sepsis, acute kidney injury, and pancreatitis, is highly dependent on the correct assessment and optimization of a patient's intravascular volume status. Therefore, it is crucial that the ED physician knows and uses available means to assess intravascular volume status to adequately guide fluid therapy. This review focuses on techniques for volume status assessment that are available in the ED including basic clinical and laboratory findings, apparatus-based tests such as sonography and chest x-ray, and functional tests to evaluate fluid responsiveness. Furthermore, we provide an outlook on promising innovative, noninvasive technologies that might be used for advanced hemodynamic monitoring in the ED.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, München, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Maurer
authors.affiliation: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: J Y
authors.initials: JY
authors.lastname: Wagner
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675, München, Germany.
authors.forename: R M
authors.initials: RM
authors.lastname: Schmid
authors.affiliation: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. bernd.saugel@gmx.de.
authors.forename: B
authors.initials: B
authors.lastname: Saugel
mesh_terms: D000208:Acute Disease / Q000628:therapy*; D001810:Blood Volume / Q000502:physiology*; D001811:Blood Volume Determination / Q000379:methods*; D004636:Emergency Service, Hospital; D005440:Fluid Therapy / Q000379:methods*; D000074743:Hemodynamic Monitoring; D006801:Humans; D013902:Radiography, Thoracic; D014463:Ultrasonography
keywords: Advanced hemodynamic monitoring; Fluid challenge; Fluid deficiency; Noninvasive cardiac output; Passive leg raising; Sepsis; Shock; Volume therapy