Mallemat: The Art and Science of Fluid Responsiveness

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

Mallemat: The Art and Science of Fluid Responsiveness

  1. 1. Leggé del CuoreMaestrini
  2. 2. Dario Maestrini
  3. 3. Normal
 Contraction Increased! Contractility
  4. 4. Frank Starling
  5. 5. Preload StrokeVolume
  6. 6. Preload StrokeVolume Preload StrokeVolume
  7. 7. Preload StrokeVolume Decrease Inotropy Increased Inotropy
  8. 8. …but not ! one drop! more!” …give all ! the fluid ! they need…“
  9. 9. Fluid Responsive
  10. 10. Static Dynamic
  11. 11. Static Dynamic
  12. 12. Invasive
  13. 13. Steve Waugh
  14. 14. Preload StrokeVolume
  15. 15. Deficit or Excess Blood Volume CVP! mmHg
  16. 16. Non-Invasive
  17. 17. ?
  18. 18. IVC ~ CVP
  19. 19. Static
  20. 20. Positive Pressure Release
  21. 21. P! P! V ulse ressure ariation
  22. 22. ExpirationInspiration
  23. 23. Maximum - Minimum Average
  24. 24. 13%
  25. 25. 13%>
  26. 26. Sinus 8cc/kg Synchrony PEEPRV Abdominal Pressure
  27. 27. Distensibility! Index
  28. 28. Positive Pressure Release
  29. 29. Expiration Inspiration
  30. 30. Distensibility Index Maximum - Minimum Average 12%
  31. 31. Distensibility Index Maximum - Minimum Minimum 18%
  32. 32. 84%
  33. 33. 4%
  34. 34. Sub-Aortic! Peak! Velocity
  35. 35. Maximum - Minimum Average
  36. 36. 12%
  37. 37. 27%
  38. 38. 9%
  39. 39. 17%
  40. 40. Expiratory Occlusion Test
  41. 41. Passive Leg Raise
  42. 42. SV
  43. 43. LVOT! Diameter
  44. 44. Stroke Distance
  45. 45. Velocity Time Integral
  46. 46. 3.14 x r2 x VTI
  47. 47. SV
  48. 48. %12
  49. 49. Dynamic
  50. 50. Art Science&
  51. 51. Thank you @criticalcarenow haney.mallemat@gmail.com

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