Prediction of fluid responsiveness in spontaneously breathing patients

被引:16
作者
Monnet, Xavier [1 ,2 ]
Teboul, Jean-Louis [1 ,2 ]
机构
[1] Hop Univ Paris Saclay, Hop Bicetre, AP HP, Serv Med Intens Reanimat, Le Kremlin Bicetre, France
[2] Univ Paris Saclay, INSERM, UMR S 999, Le Kremlin Bicetre, France
关键词
Volume expansion; passive leg raising (PLR); heart-lung interactions; END-EXPIRATORY OCCLUSION; PULSE PRESSURE VARIATION; CRITICALLY-ILL PATIENTS; TIDAL VOLUME CHALLENGE; ARTERIAL-PRESSURE; SEVERE SEPSIS; BLOOD-FLOW; 100; ML; METAANALYSIS; GUIDELINES;
D O I
10.21037/atm-2020-hdm-18
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
In patients with acute circulatory failure, the primary goal of volume expansion is to increase cardiac output. However, this expected effect is inconstant, so that in many instances, fluid administration does not result in any haemodynamic benefit. In such cases, fluid could only exert some deleterious effects. It is now well demonstrated that excessive fluid administration is harmful, especially during acute respiratory distress syndrome and in sepsis or septic shock. This is the reason why some tests and indices have been developed in order to assess "fluid responsiveness" before deciding to perform volume expansion. While preload markers have been used for many years for this purpose, they have been repeatedly shown to be unreliable, which is mainly related to physiological issues. As alternatives, "dynamic" indices have been introduced. These indices are based upon the changes in cardiac output or stroke volume resulting from various changes in preload conditions, induced by heart-lung interactions, postural manoeuvres or by the infusion of small amounts of fluids. The haemodynamic effects and the reliability of these "dynamic" indices of fluid responsiveness are now well described. From their respective advantages and limitations, it is also possible to describe their clinical interest and the clinical setting in which they are applicable.
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页数:10
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共 53 条
  • [1] How to detect a positive response to a fluid bolus when cardiac output is not measured?
    Ait-Hamou, Zakaria
    Teboul, Jean-Louis
    Anguel, Nadia
    Monnet, Xavier
    [J]. ANNALS OF INTENSIVE CARE, 2019, 9 (01)
  • [2] Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?
    Bentzer, Peter
    Griesdale, Donald E.
    Boyd, John
    MacLean, Kelly
    Sirounis, Demetrios
    Ayas, Najib T.
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2016, 316 (12): : 1298 - 1309
  • [3] Intra-Abdominal Hypertension Is Responsible for False Negatives to the Passive Leg Raising Test
    Beurton, Alexandra
    Teboul, Jean-Louis
    Girotto, Valentina
    Galarza, Laura
    Anguel, Nadia
    Richard, Christian
    Monnet, Xavier
    [J]. CRITICAL CARE MEDICINE, 2019, 47 (08) : E639 - E647
  • [4] The effects of passive leg raising may be detected by the plethysmographic oxygen saturation signal in critically ill patients
    Beurton, Alexandra
    Teboul, Jean-Louis
    Gavelli, Francesco
    Gonzalez, Filipe Andre
    Girotto, Valentina
    Galarza, Laura
    Anguel, Nadia
    Richard, Christian
    Monnet, Xavier
    [J]. CRITICAL CARE, 2019, 23 (1):
  • [5] Mini-fluid Challenge of 100 ml of Crystalloid Predicts Fluid Responsiveness in the Operating Room
    Biais, Matthieu
    de Courson, Hugues
    Lanchon, Romain
    Pereira, Bruno
    Bardonneau, Guillaume
    Griton, Marion
    Sesay, Musa
    Nouette-Gaulain, Karine
    [J]. ANESTHESIOLOGY, 2017, 127 (03) : 450 - 456
  • [6] Clinical relevance of pulse pressure variations for predicting fluid responsiveness in mechanically ventilated intensive care unit patients: the grey zone approach
    Biais, Matthieu
    Ehrmann, Stephan
    Mari, Arnaud
    Conte, Benjamin
    Mahjoub, Yazine
    Desebbe, Olivier
    Pottecher, Julien
    Lakhal, Karim
    Benzekri-Lefevre, Dalila
    Molinari, Nicolas
    Boulain, Thierry
    Lefrant, Jean-Yves
    Muller, Laurent
    [J]. CRITICAL CARE, 2014, 18 (06):
  • [7] Respiratory changes of the inferior vena cava diameter predict fluid responsiveness in spontaneously breathing patients with cardiac arrhythmias
    Bortolotti, Perrine
    Colling, Delphine
    Colas, Vincent
    Voisin, Benoit
    Dewavrin, Florent
    Poissy, Julien
    Girardie, Patrick
    Kyheng, Maeva
    Saulnier, Fabienne
    Favory, Raphael
    Preau, Sebastien
    [J]. ANNALS OF INTENSIVE CARE, 2018, 8
  • [8] DOES THE PULMONARY CAPILLARY WEDGE PRESSURE PREDICT LEFT-VENTRICULAR PRELOAD IN CRITICALLY ILL PATIENTS
    CALVIN, JE
    DRIEDGER, AA
    SIBBALD, WJ
    [J]. CRITICAL CARE MEDICINE, 1981, 9 (06) : 437 - 443
  • [9] Cecconi M, 2015, INTENS CARE MED, V41, P1737, DOI 10.1007/s00134-015-4003-y
  • [10] Predicting Fluid Responsiveness by Passive Leg Raising: A Systematic Review and Meta-Analysis of 23 Clinical Trials
    Cherpanath, Thomas G. V.
    Hirsch, Alexander
    Geerts, Bart F.
    Lagrand, Wim K.
    Leeflang, Mariska M.
    Schultz, Marcus J.
    Groeneveld, A. B. Johan
    [J]. CRITICAL CARE MEDICINE, 2016, 44 (05) : 981 - 991