Anaes Cases · Perioperative fluid & goal-directed therapy
The hypotensive patient who is not fluid-responsive
The hot case — the hypotension in the not-fluid-responsive patient. The vasopressor for the vasoplegia; the inotrope for the low cardiac output; the not more fluid; the arterial-line waveform analysis.
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Prompt
During the surgery, the blood pressure falls. The PPV is 6 per cent (below 13). The SV did not increase after the 250 mL bolus. Manage.
Presentation
During the laparotomy, the MAP falls from 80 to 55. The PPV is 6 per cent (below the 13 per cent threshold). The 250 mL bolus given — the stroke volume did not increase. Manage.[41372509]
References2ShowHide
- [4]Bertrand M, et al. Applied physiology: invasive blood pressure. Ann Intensive Care, 2025.PMID 41372508
- [41372509]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.