Related Experiment Video
Updated: Sep 21, 2025
09:32
Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
3.6K
Prediction of fluid responsiveness. What's new?
Xavier Monnet1, Rui Shi2, Jean-Louis Teboul2
1AP-HP, Service de médecine intensive-réanimation, Hôpital de Bicêtre, DMU 4 CORREVE, Inserm UMR S_999, FHU SEPSIS, CARMAS, Université Paris-Saclay, 78 rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France. xavier.monnet@aphp.fr.
Annals of Intensive Care
|May 28, 2022
Summary
This review examines recent advances in predicting fluid responsiveness for circulatory failure. New methods for passive leg raising and end-expiratory occlusion tests offer improved accuracy without invasive cardiac output monitoring.
Area of Science:
- Critical care medicine
- Hemodynamic monitoring
- Fluid resuscitation
Background:
- Fluid administration is a cornerstone of circulatory failure treatment.
- Fluid therapy presents challenges: inconsistent cardiac output response and risks of fluid overload.
- Accurate prediction of fluid responsiveness is crucial for optimizing patient outcomes.
Purpose of the Study:
- To review recent (past three years) advancements in tests predicting fluid responsiveness.
- To evaluate novel surrogates and methods for assessing fluid responsiveness.
- To discuss the limitations and applications of various fluid responsiveness prediction tests.
Main Methods:
- Review of recently published data on fluid responsiveness prediction tests.
- Detailed examination of passive leg raising test surrogates and their measurement.
- Analysis of end-expiratory occlusion test advancements and non-invasive cardiac output assessment.
- Evaluation of respiratory variation indices (pulse pressure variation, VCI diameter) and their application.
- Discussion of tidal volume challenge, mini-fluid challenge, and Trendelenburg maneuver.
Main Results:
- New stroke volume surrogates enhance passive leg raising test interpretation.
- Non-invasive methods for assessing end-expiratory occlusion test effects are emerging.
- Tidal volume challenge shows increasing reliability for predicting fluid responsiveness without direct cardiac output measurement.
- Mini-fluid challenge requires precise cardiac output measurement, with ongoing research into alternative assessment methods.
- Trendelenburg maneuver presents a potential alternative for prone patients.
Conclusions:
- Recent research offers improved, often less invasive, methods for predicting fluid responsiveness.
- Understanding the limitations of each test, particularly in specific patient populations (e.g., intra-abdominal hypertension), is essential.
- Continued development in hemodynamic monitoring aims to optimize fluid management in critical care.
Related Concept Videos
01:20Characteristics of Fluids
5.5K
When a force is applied parallel to the top surface of a solid, it resists the applied force due to the internal frictional forces between the layers of the solid known as shearing resistance. However, when the force is removed, the shearing forces restore the original shape of the solid. Other deformation forces also cause temporary changes in shape if the forces are not beyond a threshold magnitude. Solids tend to retain their shape, making the study of their rest and motion easier. Beyond...
5.5K
01:16Measurement of Fluid Pressure
319
Fluid pressure is commonly measured using devices called manometers, which rely on liquid columns to indicate pressure differences. The height of a liquid column in a manometer reflects the pressure exerted by the fluid, providing a simple yet effective means of measurement. Different types of manometers serve specific purposes based on their configurations and the type of fluids involved.
A basic form of manometer is the piezometer, a vertical tube open at the top and filled with the same...
A basic form of manometer is the piezometer, a vertical tube open at the top and filled with the same...
319
01:19Body Water Content and Fluid Compartments
2.0K
Life's biochemical processes occur within aqueous solutions. Solutes are substances that are dissolved within these solutions. The human body contains a variety of solutes, which can differ across various body parts. These can encompass proteins—such as those responsible for clotting and carbohydrate transport—as well as electrolytes. In medicine, an electrolyte is often described as a mineral ion derived from a salt possessing an electric charge. Examples include sodium ions...
2.0K
01:14Fluid Pressure
826
In mechanical engineering, fluid pressure plays a critical role in designing systems that utilize liquid flow, such as hydraulic systems, pumps, and valves. When designing these systems, engineers must ensure they can withstand the forces created by fluid pressure to avoid damage or failure.
According to Pascal's law, a fluid at rest will generate equal pressure in all directions. This pressure is measured as a force per unit area, and its magnitude depends on the fluid's specific...
According to Pascal's law, a fluid at rest will generate equal pressure in all directions. This pressure is measured as a force per unit area, and its magnitude depends on the fluid's specific...
826
01:27Types of Fluids
507
Fluids can be classified into Newtonian and non-Newtonian fluids based on their response to shear stress. Newtonian fluids have a linear relationship between shear stress and the shear strain rate, following Newton's law of viscosity. Their viscosity remains constant regardless of the shear rate, making their behavior predictable and easier to analyze. Common examples include water, air, oil, and gasoline.
In contrast, non-Newtonian fluids do not follow Newton's law of viscosity, and...
In contrast, non-Newtonian fluids do not follow Newton's law of viscosity, and...
507
01:14Pressure of Fluids
17.0K
There are many examples of pressure in fluids in everyday life, such as in relation to blood (high or low blood pressure) and in relation to weather (high- and low-pressure weather systems). A given force can have a significantly different effect, depending on the area over which the force is exerted. For instance, a force applied to an area of 1 mm2 has a pressure that is 100 times greater than the same force applied to an area of 1 cm2. That's why a sharp needle is able to poke through...
17.0K