mallemat: the art and science of fluid responsiveness
DESCRIPTION
Haney gives an erudite summary of the controversial topic of measuring and managing fluid responsiveness in shock.TRANSCRIPT
Leggé del
CuoreMaestrini
DarioMaestrini
NormalContraction
Increased!Contractility
Frank Starling
Preload
Stro
ke V
olum
e
Preload
Stro
ke V
olum
e
Preload
Stro
ke V
olum
e
Preload
Stro
ke V
olum
e
Decrease Inotropy
Increased Inotropy
…but not !one drop!more!”
…give all !the fluid !
they need…“
Fluid Responsive
Static Dynamic
Static Dynamic
Invasive
Steve Waugh
Preload
Stro
ke V
olum
e
Deficit or Excess Blood Volume
CVP!mmHg
Non-Invasive
?
IVC ~ CVP
Static
Positive Pressure Release
P!P!V
ulseressureariation
ExpirationInspiration
Maximum - Minimum Average
13%
13%>
Sinus
8cc/kg
Synchrony
PEEPRV
Abdominal Pressure
Distensibility!Index
Positive Pressure Release
Expiration
Inspiration
Distensibility Index
Maximum - Minimum Average
12%
Distensibility IndexMaximum - Minimum
Minimum
18%
84%
4%
Sub-Aortic!Peak!Velocity
Maximum - Minimum Average
12%
27%
9%
17%
Expiratory Occlusion Test
Passive Leg
Raise
SV
LVOT!
Diameter
Stroke Distance
Velocity Time Integral
3.14 x r2 x VTI
SV
%12
Dynamic
Art Science&
