Indikation und Steuerung der Volumentherapie: Das Wichtigste zuerst

BACKGROUND: Fluid therapy is a core concept in the management of perioperative and critically ill patients for maintenance of intravascular volume and organ perfusion. The clinical determination of the intravascular volume can be extremely difficult. Indication and control for intravascular volume therapy are among the most difficult aspects of intensive care.

MATERIALS AND METHODS: A literature review was performed.

RESULTS: The goal of cardiovascular therapy is to enhance adequate blood flow and oxygen delivery to the tissues to meet the varying metabolic demands of the tissues without inducing untoward cardiorespiratory complications. A careful history and clinical examination are indispensable and allow evaluation of tissue and organ perfusion. Laboratory examinations, bedside ultrasonography as well as invasive hemodynamic monitoring complete the assessment and allow guidance of fluid therapy.

CONCLUSIONS: Case history, clinical examinations, bedside ultrasonography, and invasive hemodynamic monitoring complete the assessment and allow clinicians to assess volume responsiveness.