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Chapter 8 - Point-of-Care Ultrasound: Determination of Fluid Responsiveness

Published online by Cambridge University Press:  28 April 2020

By
Subhash Krishnamoorthy  and
Oliver Panzer
Edited by
Andrew B. Leibowitz  and
Suzan Uysal
Andrew B. Leibowitz
Affiliation:
Icahn School of Medicine at Mount Sinai
Suzan Uysal
Affiliation:
Icahn School of Medicine at Mount Sinai
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Summary

Hypotension and shock in the perioperative setting may arise from a variety of etiologies. A common initial intervention is administration of a fluid bolus to increase the cardiac stroke volume and mean arterial blood pressure; however, up to 50% of all hypotensive patients do not have the desired hemodynamic response, and excessive fluid administration may be harmful. There is a clinical need to determine the likelihood that an individual patient will respond to fluid administration, and use of dynamic parameters is becoming routine. The respiratory variation of stroke volume associated with positive pressure ventilation (heart–lung interaction model) and the passive leg raise (endogenous fluid challenge model) are the two best-validated means to quickly augment stroke volume. This chapter will review ultrasound-based parameters such as inferior vena cava diameter change and velocity time integral variation utilizing these two methods of stroke volume augmentation to predict fluid responsiveness.

Keywords

Fluid responsivenessultrasoundinferior vena cavavelocity time indexpulse wave Doppler
Type
Chapter
Information
Modern Monitoring in Anesthesiology and Perioperative Care , pp. 80 - 91
Publisher: Cambridge University Press
Print publication year: 2020

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