ICU SAQs · Resuscitation
Fluid responsiveness — when to give fluid, and how to judge it
A CICM Second-Part SAQ on fluid responsiveness — why the central venous pressure does not predict it (Marik), the dynamic indices (pulse-pressure variation — Michard) and the passive leg raise (Monnet), and the principle that only the responsive patient benefits.
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CICMFFICMEDIC
Prompt
Outline how you decide whether a critically ill patient will benefit from a fluid bolus. Justify your choice of assessment method and the dose and limits of a fluid challenge.
Question
Outline how you decide whether a critically ill patient will benefit from a fluid bolus. Justify your choice of assessment method and the dose and limits of a fluid challenge.
[2]References4ShowHide
- [1]Marik PE, Baram M, Vahid B. Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. Chest, 2008.PMID 18628220
- [2]Michard F, Boussat S, Chemla D, et al. Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. American Journal of Respiratory and Critical Care Medicine, 2000.PMID 10903232
- [3]Monnet X, Rienzo M, Osman D, et al. Passive leg raising predicts fluid responsiveness in the critically ill. Critical Care Medicine, 2006.PMID 16540963
- [4]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.