Predicting fluid responsiveness in mechanically ventilated patients

研究成果: Review article

摘要

Fluid resuscitation is a frequent therapeutic strategy iintensive care unit. It is important to evaluate the volume status of patients and predict the fluid responsiveness before starting fluid therapy and to avoid the complication due to excessive fluid loading. But it is a challenging issue in mechanically ventilated patients. In paralytic and ventilator-dependent patients, the positive-pressure inspiration pattern which is opposing to spontaneous negative-pressure inspiration pattern in normal subjects leads to continuous and complex interaction with cardiovascular system. The results limit the efficacy of static parameters, such as central venous pressure, right atrial pressure, pulmonary capillary wedge pressure, right and left end-diastolic ventricular volume, in evaluating the volume status and predicting fluid responsiveness of ventilated patients. On the other hand, the dynamic parameters, such as systolic pressure variation, stroke volume variation, pulse pressure variation, were demonstrated to be useful in predicting fluid responsiveness of ventilated patients in clinical studies. In clinical practice, we may decide the most appropriate fluid resuscitation strategy according to these dynamic parameters as well as the individual condition of each patient, such as comorbid diseases, ventilator setting, coexisting spontaneous breathing or not, etc. and decrease the possible damage by excessive fluid loading.

原文English
頁(從 - 到)285-293
頁數9
期刊Journal of Internal Medicine of Taiwan
20
發行號4
出版狀態Published - 2009 八月 1

指紋

Mechanical Ventilators
Resuscitation
Stroke Volume
Blood Pressure
Pressure
Central Venous Pressure
Pulmonary Wedge Pressure
Atrial Pressure
Fluid Therapy
Cardiovascular System
Respiration
Therapeutics
Clinical Studies

All Science Journal Classification (ASJC) codes

  • Internal Medicine

引用此文

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abstract = "Fluid resuscitation is a frequent therapeutic strategy iintensive care unit. It is important to evaluate the volume status of patients and predict the fluid responsiveness before starting fluid therapy and to avoid the complication due to excessive fluid loading. But it is a challenging issue in mechanically ventilated patients. In paralytic and ventilator-dependent patients, the positive-pressure inspiration pattern which is opposing to spontaneous negative-pressure inspiration pattern in normal subjects leads to continuous and complex interaction with cardiovascular system. The results limit the efficacy of static parameters, such as central venous pressure, right atrial pressure, pulmonary capillary wedge pressure, right and left end-diastolic ventricular volume, in evaluating the volume status and predicting fluid responsiveness of ventilated patients. On the other hand, the dynamic parameters, such as systolic pressure variation, stroke volume variation, pulse pressure variation, were demonstrated to be useful in predicting fluid responsiveness of ventilated patients in clinical studies. In clinical practice, we may decide the most appropriate fluid resuscitation strategy according to these dynamic parameters as well as the individual condition of each patient, such as comorbid diseases, ventilator setting, coexisting spontaneous breathing or not, etc. and decrease the possible damage by excessive fluid loading.",
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AU - Hsu, Chin-Hsin

AU - Lee, Wei-Ting

AU - Lin, Wei-Chieh

AU - Chen, Chang-Wen

PY - 2009/8/1

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N2 - Fluid resuscitation is a frequent therapeutic strategy iintensive care unit. It is important to evaluate the volume status of patients and predict the fluid responsiveness before starting fluid therapy and to avoid the complication due to excessive fluid loading. But it is a challenging issue in mechanically ventilated patients. In paralytic and ventilator-dependent patients, the positive-pressure inspiration pattern which is opposing to spontaneous negative-pressure inspiration pattern in normal subjects leads to continuous and complex interaction with cardiovascular system. The results limit the efficacy of static parameters, such as central venous pressure, right atrial pressure, pulmonary capillary wedge pressure, right and left end-diastolic ventricular volume, in evaluating the volume status and predicting fluid responsiveness of ventilated patients. On the other hand, the dynamic parameters, such as systolic pressure variation, stroke volume variation, pulse pressure variation, were demonstrated to be useful in predicting fluid responsiveness of ventilated patients in clinical studies. In clinical practice, we may decide the most appropriate fluid resuscitation strategy according to these dynamic parameters as well as the individual condition of each patient, such as comorbid diseases, ventilator setting, coexisting spontaneous breathing or not, etc. and decrease the possible damage by excessive fluid loading.

AB - Fluid resuscitation is a frequent therapeutic strategy iintensive care unit. It is important to evaluate the volume status of patients and predict the fluid responsiveness before starting fluid therapy and to avoid the complication due to excessive fluid loading. But it is a challenging issue in mechanically ventilated patients. In paralytic and ventilator-dependent patients, the positive-pressure inspiration pattern which is opposing to spontaneous negative-pressure inspiration pattern in normal subjects leads to continuous and complex interaction with cardiovascular system. The results limit the efficacy of static parameters, such as central venous pressure, right atrial pressure, pulmonary capillary wedge pressure, right and left end-diastolic ventricular volume, in evaluating the volume status and predicting fluid responsiveness of ventilated patients. On the other hand, the dynamic parameters, such as systolic pressure variation, stroke volume variation, pulse pressure variation, were demonstrated to be useful in predicting fluid responsiveness of ventilated patients in clinical studies. In clinical practice, we may decide the most appropriate fluid resuscitation strategy according to these dynamic parameters as well as the individual condition of each patient, such as comorbid diseases, ventilator setting, coexisting spontaneous breathing or not, etc. and decrease the possible damage by excessive fluid loading.

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