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Volume responsiveness.

Xavier Monnet1, Jean-Louis Teboul

  • 1Medical Intensive Care Unit, Bicêtre University Hospital, Paris-11 University, Le Kremlin-Bicêtre, France.

Current Opinion in Critical Care
|September 1, 2007
PubMed
Summary
This summary is machine-generated.

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Predicting fluid responsiveness in ICU patients is crucial. The passive leg raising test is a reliable method for predicting volume responsiveness in patients with spontaneous breathing activity.

Area of Science:

  • Critical Care Medicine
  • Hemodynamics
  • Cardiovascular Physiology

Background:

  • Only 50% of ICU patients are fluid responsive.
  • Predicting fluid responsiveness is essential for managing circulatory failure.
  • Spontaneous breathing activity complicates traditional fluid responsiveness assessment.

Purpose of the Study:

  • To summarize methods for predicting fluid responsiveness.
  • To focus on recent findings in spontaneously breathing patients.
  • To identify reliable predictors of volume responsiveness.

Main Methods:

  • Review of recent studies on fluid responsiveness prediction.
  • Evaluation of passive leg raising as a predictive test.
  • Assessment of hemodynamic response to passive leg raising.

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Main Results:

  • Passive leg raising is a reliable predictor of fluid responsiveness.
  • This maneuver transiently increases cardiac preload.
  • Real-time measurement of cardiac output or surrogates is needed.
  • Traditional methods like respiratory variations are less reliable in spontaneously breathing patients.

Conclusions:

  • Numerous methods exist for predicting fluid responsiveness.
  • Passive leg raising is a reliable method for spontaneously breathing patients.
  • Respiratory variations are useful in fully ventilated patients.