Abstract
Estimation of intravascular volume status by clinical examination and static measurements such as central venous pressure and pulmonary capillary wedge pressure do not predict fluid responsiveness. Current evidence indicates that dynamic monitoring of arterial pressure and derived indices are the most sensitive and specific means of determining fluid responsiveness, especially in mechanically ventilated patients. Several monitors that automate and embellish this approach, a few of which are noninvasive, are now commercially available and they are gradually being incorporated into intensive and perioperative care practice. This chapter reviews the physiologic underpinnings of how and why the arterial pressure waveform can be used to determine fluid responsiveness and gives an overview of the devices incorporating these principles.
| Original language | English (US) |
|---|---|
| Title of host publication | Modern Monitoring in Anesthesiology and Perioperative Care |
| Publisher | Cambridge University Press |
| Pages | 109-116 |
| Number of pages | 8 |
| ISBN (Electronic) | 9781108610650 |
| ISBN (Print) | 9781108444910 |
| DOIs | |
| State | Published - Jan 1 2020 |
Bibliographical note
Publisher Copyright:© Cambridge University Press 2020.
Keywords
- fluid responsiveness
- goal-directed therapy
- Intravascular volume
- perfusion index
- pleth variability index
- plethysmography
- pulse pressure variation
- stroke volume variation
