Erschienen in:
07.01.2020 | Editorial
Update on the assessment of fluid responsiveness
verfasst von:
Koichi Suehiro
Erschienen in:
Journal of Anesthesia
|
Ausgabe 2/2020
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Excerpt
Hemodynamic fluctuations, including hypotension and decreases in cardiac output (CO), frequently occur during general anesthesia and can lead to acute circulatory failure. Under these circumstances, fluid loading is the first-line therapeutic method. However, excessive fluid volume expansion can be harmful, especially in patients with heart disease. As patients with acute circulatory failure do not usually respond to fluid loading by increasing their CO, numerous studies [
1‐
3] have been conducted to develop tests that predict “fluid responsiveness”. Although static indices, such as central venous pressure and pulmonary capillary wedge pressure, have been traditionally used for assessing patients’ volume status, these indices have poor reliability for identifying fluid responders [
4]. Dynamic indices, including pulse pressure variation (PPV) and stroke volume variation (SVV), have been recently used, and they provide better predictability for fluid responsiveness [
5,
6]. Recent advances in minimally invasive hemodynamic monitoring allow for an increased clinical applicability of these indices [
7‐
10]. Goal-directed therapy using dynamic indices decreases postoperative morbidity under various clinical conditions [
11‐
13]. …