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Mallemat: The Art and Science of Fluid Responsiveness

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SMACC Conference
SMACC Conference

Haney gives an erudite summary of the controversial topic of measuring and managing fluid responsiveness in shock.

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Leggé del CuoreMaestrini
Dario Maestrini
Normal
 Contraction Increased! Contractility
Frank Starling
Preload StrokeVolume
Preload StrokeVolume Preload StrokeVolume
Preload StrokeVolume Decrease Inotropy Increased Inotropy
…but not ! one drop! more!” …give all ! the fluid ! they need…“
Fluid Responsive
Static Dynamic
Static Dynamic
Invasive
Steve Waugh
Preload StrokeVolume
Deficit or Excess Blood Volume CVP! mmHg
Non-Invasive
?
IVC ~ CVP
Static
Positive Pressure Release
P! P! V ulse ressure ariation
ExpirationInspiration
Maximum - Minimum Average
13%
13%>
Sinus 8cc/kg Synchrony PEEPRV Abdominal Pressure
Distensibility! Index
Positive Pressure Release
Expiration Inspiration
Distensibility Index Maximum - Minimum Average 12%
Distensibility Index Maximum - Minimum Minimum 18%
84%
4%
Sub-Aortic! Peak! Velocity
Maximum - Minimum Average
12%
27%
9%
17%
Expiratory Occlusion Test
Passive Leg Raise
SV
LVOT! Diameter
Stroke Distance
Velocity Time Integral
3.14 x r2 x VTI
SV
%12
Dynamic
Art Science&
Thank you @criticalcarenow haney.mallemat@gmail.com

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