Skip to main content
Top
Published in: Critical Care 5/2006

01-10-2006 | Commentary

Predicting volume responsiveness in spontaneously breathing patients: still a challenging problem

Author: S Magder

Published in: Critical Care | Issue 5/2006

Login to get access

Abstract

The prediction of which patients respond to fluid infusion and which patients do not is an important issue in the intensive care setting. Assessment of this response by monitoring changes in some hemodynamic characteristics in relation to spontaneous breathing efforts would be very helpful for the management of the critically ill. This unfortunately remains a difficult clinical problem, as discussed in the previous issue of the journal. Technical factors and physiological factors limit the usefulness of current techniques.
Literature
1.
go back to reference Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin A: Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006, 354: 2564-2575. 10.1056/NEJMoa062200CrossRefPubMed Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin A: Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006, 354: 2564-2575. 10.1056/NEJMoa062200CrossRefPubMed
2.
go back to reference Magder S: More respect for the CVP. Int Care Med 1998, 24: 651-653. 10.1007/s001340050640CrossRef Magder S: More respect for the CVP. Int Care Med 1998, 24: 651-653. 10.1007/s001340050640CrossRef
3.
go back to reference Perel A, Pizov R, Cotev S: Systolic blood pressure variation is a sensitive indicator of hypovelemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 1987, 67: 498-502.CrossRefPubMed Perel A, Pizov R, Cotev S: Systolic blood pressure variation is a sensitive indicator of hypovelemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 1987, 67: 498-502.CrossRefPubMed
4.
go back to reference Michard F, Chemla D, Richard C, Wysocki M, Pinsky MR, Lecarpentier Y, Teboul J-L: Clinical use of respiratory changes in arterial pulse pressure to monitor the hemodynamic effects of PEEP. Am J Respir Crit Care Med 1999, 159: 935-939.CrossRefPubMed Michard F, Chemla D, Richard C, Wysocki M, Pinsky MR, Lecarpentier Y, Teboul J-L: Clinical use of respiratory changes in arterial pulse pressure to monitor the hemodynamic effects of PEEP. Am J Respir Crit Care Med 1999, 159: 935-939.CrossRefPubMed
5.
go back to reference Magder S: Clinical usefulness of respiratory variations in arterial pressure. Am J Resp Crit Care Med 2004, 169: 151-155. 10.1164/rccm.200211-1360CCCrossRefPubMed Magder S: Clinical usefulness of respiratory variations in arterial pressure. Am J Resp Crit Care Med 2004, 169: 151-155. 10.1164/rccm.200211-1360CCCrossRefPubMed
6.
go back to reference Rooke GA, Schwid HA, Shapira Y: The effect of graded hemorrhage and intravascular volume replacement on systolic pressure variation in humans during mechanical and spontaneous ventilation. Anesth Analg 1995, 80: 925-932. 10.1097/00000539-199505000-00012PubMed Rooke GA, Schwid HA, Shapira Y: The effect of graded hemorrhage and intravascular volume replacement on systolic pressure variation in humans during mechanical and spontaneous ventilation. Anesth Analg 1995, 80: 925-932. 10.1097/00000539-199505000-00012PubMed
7.
go back to reference Heenen S, De Backer D, Vincent JL: How can the response to volume expansion in patients with spontaneous respiratory movements be predicted? Crit Care 2006, 10: R102. 10.1186/cc4970PubMedCentralCrossRefPubMed Heenen S, De Backer D, Vincent JL: How can the response to volume expansion in patients with spontaneous respiratory movements be predicted? Crit Care 2006, 10: R102. 10.1186/cc4970PubMedCentralCrossRefPubMed
8.
go back to reference Magder SA, Georgiadis G, Cheong T: Respiratory variations in right atrial pressure predict response to fluid challenge. J Crit Care 1992, 7: 76-85. 10.1016/0883-9441(92)90032-3CrossRef Magder SA, Georgiadis G, Cheong T: Respiratory variations in right atrial pressure predict response to fluid challenge. J Crit Care 1992, 7: 76-85. 10.1016/0883-9441(92)90032-3CrossRef
9.
go back to reference Magder S, Lagonidis D, Erice F: The use of respiratory variations in right atrial pressure to predict the cardiac output response to PEEP. J Crit Care 2002, 16: 108-114. 10.1053/jcrc.2001.28194CrossRef Magder S, Lagonidis D, Erice F: The use of respiratory variations in right atrial pressure to predict the cardiac output response to PEEP. J Crit Care 2002, 16: 108-114. 10.1053/jcrc.2001.28194CrossRef
10.
go back to reference Magder S, Lagonidis D: Effectiveness of albumin versus normal saline to test volume responsiveness in post-cardiac surgery patients. J Crit Care 1999, 14: 164-171. 10.1016/S0883-9441(99)90030-8CrossRefPubMed Magder S, Lagonidis D: Effectiveness of albumin versus normal saline to test volume responsiveness in post-cardiac surgery patients. J Crit Care 1999, 14: 164-171. 10.1016/S0883-9441(99)90030-8CrossRefPubMed
Metadata
Title
Predicting volume responsiveness in spontaneously breathing patients: still a challenging problem
Author
S Magder
Publication date
01-10-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5029

Other articles of this Issue 5/2006

Critical Care 5/2006 Go to the issue