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Assessment of indices of preload and volume responsiveness

Pinsky, MR (2005) Assessment of indices of preload and volume responsiveness. Current Opinion in Critical Care, 11 (3). 235 - 239. ISSN 1070-5295

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Purpose of review: To summarize the relevant peer-reviewed publications over the past year that addressed issues of when to give (or not give) fluid to the critically ill patient. Recent findings: Clinical data from several studies underscore the inability of measures of ventricular filling to assess either preload or preload responsiveness. Whereas less invasive monitoring techniques than pulmonary arterial catheterization demonstrate better discriminations with estimates of both preload and preload responsiveness. Measuring dynamic changes in stroke volume, descending aortic flow, and both superior and inferior vena caval diameters during ventilation provides good predictive value in defining preload responsiveness. One study demonstrated that resuscitation protocols keyed to esophageal flow measures improved outcome in postoperative cardiac surgery patients. Summary: Preload is not preload responsiveness. Functional measures of preload responsiveness exist and are superior to traditional measures of filling pressures in driving resuscitation in critically ill patients. © 2005 Lippincott Williams & Wilkins.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 June 2005
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: Current Opinion in Critical Care
Volume: 11
Number: 3
Page Range: 235 - 239
DOI or Unique Handle: 10.1097/01.ccx.0000158848.56107.b1
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 1070-5295
Article Type: Review
Date Deposited: 14 Jul 2012 19:40
Last Modified: 30 Jan 2020 16:55


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