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Author Lee, Christopher W. C. ♦ Kory, Pierre D. ♦ Arntfield, Robert T.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human anatomy, cytology, histology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Management & auxiliary services ♦ General management ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Respiratory System ♦ Cardiovascular System ♦ Fluids and Secretions ♦ Anatomy ♦ Eukaryota ♦ Organisms ♦ Pathological Conditions, Signs and Symptoms ♦ Diseases ♦ Diagnosis ♦ Therapeutics ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Health Services Administration ♦ Health Care
Subject Keyword Discipline Critical Care ♦ Extravascular Lung Water ♦ Fluid Therapy ♦ Methods ♦ Lung ♦ Resuscitation ♦ Shock ♦ Therapy ♦ Vena Cava, Inferior ♦ Cardiac Output ♦ Physiology ♦ Clinical Protocols ♦ Critical Care ♦ Critical Illness ♦ Adverse Effects ♦ Humans ♦ Point-of-care Systems ♦ Practice Guidelines As Topic ♦ Ultrasonography ♦ Journal Article ♦ Review
Abstract Appropriate fluid resuscitation has been a major focus of critical care medicine since its inception. Currently, the most accurate method to guide fluid administration decisions uses 'dynamic' measures that estimate the change in cardiac output that would occur in response to a fluid bolus. Unfortunately, their use remains limited due to required technical expertise, costly equipment, or applicability in only a subset of patients. Alternatively, point-of-care ultrasound (POCUS) has become widely used as a tool to help clinicians prescribe fluid therapy. Common POCUS applications that serve as guides to fluid administration rely on assessments of the inferior vena cava to estimate preload and lung ultrasound to identify the early presence of extravascular lung water and avoid fluid overresuscitation. Although application of these POCUS measures has multiple limitations that are commonly misunderstood, current evidence suggests that they can be used in combination to sort patients among 3 fluid management categories: (1) fluid resuscitate, (2) fluid test, and (3) fluid restrict. This article reviews the pertinent literature describing the use of inferior vena cava and lung ultrasound for fluid responsiveness and presents an evidence-informed algorithm using these measures to guide fluid resuscitation decisions in the critically ill.
Description Country affiliation: Canada
Author Affiliation: Lee CW ( Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.); Kory PD ( Division of Allergy, Pulmonary, and Critical Care, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI, USA.); Arntfield RT ( Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2016-02-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 31
Issue Number 1


Source: WHO-Global Index Medicus