Presentation is loading. Please wait.

Presentation is loading. Please wait.

Kambiz Kalantari, Jamison N. Chang, Claudio Ronco, Mitchell H. Rosner 

Similar presentations


Presentation on theme: "Kambiz Kalantari, Jamison N. Chang, Claudio Ronco, Mitchell H. Rosner "— Presentation transcript:

1 Assessment of intravascular volume status and volume responsiveness in critically ill patients 
Kambiz Kalantari, Jamison N. Chang, Claudio Ronco, Mitchell H. Rosner  Kidney International  Volume 83, Issue 6, Pages (June 2013) DOI: /ki Copyright © 2013 International Society of Nephrology Terms and Conditions

2 Figure 1 Volume assessment goals. Proper assessment of patients’ volume status and whether they will respond with an increase in cardiac output, following a fluid challenge, are critical to avoid the consequences of either inadequate or overaggressive fluid therapy. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions

3 Figure 2 Preload does not predict volume responsiveness. For a given fixed amount of fluid administration, the increase in stroke volume will be greater for a patient with normal ventricular function (A, preload-dependent and fluid-responsive) than for a patient with impaired ventricular function (B, preload-independent and fluid-nonresponsive). However, a static measurement of preload would be the same in each patient. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions

4 Figure 3 Respiratory variations in cardiac hemodynamics in the mechanically ventilated patient. Mechanical ventilation results in a decrease in left ventricular output during the expiratory phase that can be seen by changes in the arterial pressure wave form. These changes form the basis of stroke volume variation and pulse pressure variation. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions

5 Figure 4 Bioimpedance vector analysis. Shown here are the ellipses of the standard vectors of the 50th, 75th, and 95th percentiles of the normal population, as well as two vectors from hypothetical patients. In patient A, the short vector represents total body water excess, whereas the longer vector for patient B is indicative of lower total body water and falls within the 95th percentile of the normal population. Kidney International  , DOI: ( /ki ) Copyright © 2013 International Society of Nephrology Terms and Conditions


Download ppt "Kambiz Kalantari, Jamison N. Chang, Claudio Ronco, Mitchell H. Rosner "

Similar presentations


Ads by Google