Fluid responsiveness in spontaneously breathing patients : a review of indexes used in intensive care

Article Article scientifique Revue de la littérature Fluid responsiveness in spontaneously breathing patients : a review of indexes used in intensive care eng 2005-12 author Coudray Alice Frédérique Geneva University Hospital, Geneva, Switzerland. 503259 author Romand Jacques-André 121831 author Treggiari Venzi Miriam-Monica 127903 author Bendjelid Karim 0000-0002-7921-7207 527948 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) 2757-2762 10.1097/01.ccm.0000189942.24113.65 16352956 0090-3493 https://journals.lww.com/ccmjournal/fulltext/2005/12000/fluid_responsiveness_in_spontaneously_breathing.6.aspx Objective: In spontaneously breathing patients, indexes predicting hemodynamic response to volume expansion are very much needed. The present review discusses the clinical utility and accuracy of indexes tested as bedside indicators of preload reserve and fluid responsiveness in hypotensive, spontaneously breathing patients. Data source: We conducted a literature search of the MEDLINE database and the trial register of the Cochrane Group. Study selection: Identification of reports investigating, prospectively, indexes of fluid responsiveness in spontaneously breathing critically ill patients. All the studies defined the response to fluid therapy after measuring cardiac output and stroke volume using the thermodilution technique. We did not score the methodological quality of the included studies before the data analysis. Data extraction: A total of eight prospective clinical studies in critically ill patients were included. Only one publication evaluated cardiac output changes induced by fluid replacement in a selected population of spontaneously breathing critically ill patients. Data synthesis: Based on this review, we can only conclude that static indexes are valuable tools to confirm that the fluid volume infused reaches the cardiac chambers, and therefore these indexes inform about changes in cardiac preload. However, respiratory variation in right atrial pressure, which represents a dynamic measurement, seems to identify hypotension related to a decrease in preload and to distinguish between responders and nonresponders to a fluid challenge. Conclusions: Further studies should address the question of the role of static indexes in predicting cardiac output improvement following fluid infusion in spontaneously breathing patients. Blood Volume Determination / methods Fluid Therapy / methods Hemodynamics / physiology Humans Plasma Volume / physiology Respiration Water-Electrolyte Balance / physiology Dewey 617 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 570 Groupe de recherche en hémodynamique 913 Critical care medicine 33 12 d582390d-d467-449a-8ee7-c4d6bf24e9fc Article (Published version) Restricted SBP_review.pdf 238557 application/pdf 35300eb0fd78c7e044f585da3055e2dddc8a0dad0cf04e676f615589291738c9 restrictedAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Fluid responsiveness in spontaneously breathing patients : a review of indexes used in intensive care	Critical care medicine			2005	62	0

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Coudray, Alice Frédérique