Assessment of volume responsiveness during mechanical ventilation: recent advances
Hôpitaux universitaires Paris-Sud, Hôpital de Bicêtre, service de reanimation médicale, Univ Paris-Sud, EA4533, 78, rue du Général Leclerc, Le Kremlin-Bicêtre, F-94270 France
Critical Care 2013, 17:217 doi:10.1186/cc12526
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2013 and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/annualupdate2013. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.Published: 19 March 2013
First paragraph (this article has no abstract)
Predicting which patients with acute circulatory failure will respond to fluid by a significant increase in cardiac output is a daily challenge, in particular in the setting of the intensive care unit (ICU). This challenge has become even more crucial because evidence is growing that administering excessive amounts of fluid is a risk factor in critically ill patients, in particular in patients with lung injury. However, some tests and indices allow prediction of fluid responsiveness before intravenous fluids are infused. In patients receiving mechanical ventilation, the arterial pulse pressure variation (PPV) has been used for many years. More recently, other tests, which may overcome some limitations of PPV, have been developed. In addition, recent studies have emphasized how the hemodynamic effects of volume expansion should be assessed once fluid has been administered.