Key result
Dynamic hemodynamic indices outperform static pressures for predicting fluid responsiveness in shock.
Why the study?
Simple measures of arterial or central venous pressure are poor indicators of hypovolaemia and fluid responsiveness, necessitating better predictors based on preload variation.
Dynamic haemodynamic indices based on preload variation during the respiratory cycle are more powerful predictors of fluid responsiveness than static measures of arterial or central venous pressure.
Dynamic preload measures may guide fluid resuscitation in trauma shock; leaves open prospective validation before practice change.
Intravenous fluid infusion is a simple way of improving cardiac output and oxygen delivery in shock. However, the consequences of fluid overload can be serious. Direct measurement of cardiac output after fluid administration may not always be feasible and simple measures of arterial or central venous pressure are poor indicators of hypovolaemia and fluid responsiveness. Measures based on the change in these parameters with variation in preload such as occurs during the respiratory cycle are more powerful predictors of the cardiovascular response to filling as they relate to the shape of the cardiac output performance curve. In this article, we describe the origin, interpretation and limitations of such dynamic indices.
No takes yet. Share an insight, caveat, or question.
Ari Ercole (2007) conducted a review in Shock. Dynamic haemodynamic indices vs. Static measures of arterial or central venous pressure was evaluated on Fluid responsiveness. Dynamic haemodynamic indices based on preload variations during the respiratory cycle are more powerful predictors of fluid responsiveness in shock than static measures of venous or arterial pressure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: