title: Assessing volume status and fluid responsiveness in the emergency department.
abstract: Resuscitation with intravenous fluid can restore intravascular volume and improve stroke volume. However, in unstable patients, approximately 50% of fluid boluses fail to improve cardiac output as intended. Increasing evidence suggests that excess fluid may worsen patient outcomes. Clinical examination and vital signs are unreliable predictors of the response to a fluid challenge. We review the importance of fluid management in the critically ill, methods of evaluating volume status, and tools to predict fluid responsiveness.
authors.affiliation: Department of Emergency Medicine, Maine Medical Center, Portland, ME, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Mackenzie
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Vicki E
authors.initials: VE
authors.lastname: Noble
keywords: Hemodynamics; Shock; Ultrasonography