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Prediction of fluid responsiveness in patients admitted to the medical intensive care unit

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Prediction of fluid responsiveness in patients admitted to the medical intensive care unit. / Saugel, Bernd; Kirsche, Stephanie V; Hapfelmeier, Alexander; Phillip, Veit; Schultheiss, Caroline; Schmid, Roland M; Huber, Wolfgang.

In: J CRIT CARE, Vol. 28, No. 4, 01.08.2013, p. 537.e1-9.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Saugel, B, Kirsche, SV, Hapfelmeier, A, Phillip, V, Schultheiss, C, Schmid, RM & Huber, W 2013, 'Prediction of fluid responsiveness in patients admitted to the medical intensive care unit', J CRIT CARE, vol. 28, no. 4, pp. 537.e1-9. https://doi.org/10.1016/j.jcrc.2012.10.008

APA

Saugel, B., Kirsche, S. V., Hapfelmeier, A., Phillip, V., Schultheiss, C., Schmid, R. M., & Huber, W. (2013). Prediction of fluid responsiveness in patients admitted to the medical intensive care unit. J CRIT CARE, 28(4), 537.e1-9. https://doi.org/10.1016/j.jcrc.2012.10.008

Vancouver

Saugel B, Kirsche SV, Hapfelmeier A, Phillip V, Schultheiss C, Schmid RM et al. Prediction of fluid responsiveness in patients admitted to the medical intensive care unit. J CRIT CARE. 2013 Aug 1;28(4):537.e1-9. https://doi.org/10.1016/j.jcrc.2012.10.008

Bibtex

@article{824241886422442d93d1a99eaaa746fa,
title = "Prediction of fluid responsiveness in patients admitted to the medical intensive care unit",
abstract = "PURPOSE: Accurate prediction of fluid responsiveness is of importance in the treatment of patients admitted to the intensive care unit (ICU). We investigated whether physical examination, central venous pressure (CVP), central venous oxygen saturation (ScvO2), passive leg raising (PLR) test, and transpulmonary thermodilution (TPTD)-derived parameters can predict volume responsiveness in patients admitted to the ICU.MATERIALS AND METHODS: In this prospective study, structured clinical examination, measurement of CVP and ScvO2, a PLR test, and TPTD measurements were performed in 31 patients. A fluid challenge test was performed in 24 patients (fluid responsiveness was defined as a cardiac index [CI] increase of ≥ 15%).RESULTS: Physical examination, CVP, ScvO2, the PLR test, and the TPTD-derived volumetric preload parameter global end-diastolic volume index showed poor prognostic capabilities regarding prediction of fluid responsiveness. Twenty-nine percent of patients were fluid responsive. There was a statistically significant correlation between the fluid challenge-induced increase in CI and changes in global end-diastolic volume index (r = 0.666, P < .001). In only 17% of patients, CI did not increase after fluid loading.CONCLUSIONS: Prediction of fluid responsiveness is difficult using physical examination, CVP, ScvO2, PLR maneuver, or TPTD-derived variables in critically ill patients. A volume challenge test should be considered for the assessment of fluid responsiveness in critically ill patients admitted to the ICU.",
keywords = "Aged, Central Venous Pressure, Critical Illness, Female, Fluid Therapy, Hemodynamics, Humans, Intensive Care, Intensive Care Units, Leg, Male, Middle Aged, Oxygen, Physical Examination, Predictive Value of Tests, Prognosis, Prospective Studies, Statistics, Nonparametric, Thermodilution",
author = "Bernd Saugel and Kirsche, {Stephanie V} and Alexander Hapfelmeier and Veit Phillip and Caroline Schultheiss and Schmid, {Roland M} and Wolfgang Huber",
note = "Copyright {\textcopyright} 2013 Elsevier Inc. All rights reserved.",
year = "2013",
month = aug,
day = "1",
doi = "10.1016/j.jcrc.2012.10.008",
language = "English",
volume = "28",
pages = "537.e1--9",
journal = "J CRIT CARE",
issn = "0883-9441",
publisher = "Elsevier BV",
number = "4",

}

RIS

TY - JOUR

T1 - Prediction of fluid responsiveness in patients admitted to the medical intensive care unit

AU - Saugel, Bernd

AU - Kirsche, Stephanie V

AU - Hapfelmeier, Alexander

AU - Phillip, Veit

AU - Schultheiss, Caroline

AU - Schmid, Roland M

AU - Huber, Wolfgang

N1 - Copyright © 2013 Elsevier Inc. All rights reserved.

PY - 2013/8/1

Y1 - 2013/8/1

N2 - PURPOSE: Accurate prediction of fluid responsiveness is of importance in the treatment of patients admitted to the intensive care unit (ICU). We investigated whether physical examination, central venous pressure (CVP), central venous oxygen saturation (ScvO2), passive leg raising (PLR) test, and transpulmonary thermodilution (TPTD)-derived parameters can predict volume responsiveness in patients admitted to the ICU.MATERIALS AND METHODS: In this prospective study, structured clinical examination, measurement of CVP and ScvO2, a PLR test, and TPTD measurements were performed in 31 patients. A fluid challenge test was performed in 24 patients (fluid responsiveness was defined as a cardiac index [CI] increase of ≥ 15%).RESULTS: Physical examination, CVP, ScvO2, the PLR test, and the TPTD-derived volumetric preload parameter global end-diastolic volume index showed poor prognostic capabilities regarding prediction of fluid responsiveness. Twenty-nine percent of patients were fluid responsive. There was a statistically significant correlation between the fluid challenge-induced increase in CI and changes in global end-diastolic volume index (r = 0.666, P < .001). In only 17% of patients, CI did not increase after fluid loading.CONCLUSIONS: Prediction of fluid responsiveness is difficult using physical examination, CVP, ScvO2, PLR maneuver, or TPTD-derived variables in critically ill patients. A volume challenge test should be considered for the assessment of fluid responsiveness in critically ill patients admitted to the ICU.

AB - PURPOSE: Accurate prediction of fluid responsiveness is of importance in the treatment of patients admitted to the intensive care unit (ICU). We investigated whether physical examination, central venous pressure (CVP), central venous oxygen saturation (ScvO2), passive leg raising (PLR) test, and transpulmonary thermodilution (TPTD)-derived parameters can predict volume responsiveness in patients admitted to the ICU.MATERIALS AND METHODS: In this prospective study, structured clinical examination, measurement of CVP and ScvO2, a PLR test, and TPTD measurements were performed in 31 patients. A fluid challenge test was performed in 24 patients (fluid responsiveness was defined as a cardiac index [CI] increase of ≥ 15%).RESULTS: Physical examination, CVP, ScvO2, the PLR test, and the TPTD-derived volumetric preload parameter global end-diastolic volume index showed poor prognostic capabilities regarding prediction of fluid responsiveness. Twenty-nine percent of patients were fluid responsive. There was a statistically significant correlation between the fluid challenge-induced increase in CI and changes in global end-diastolic volume index (r = 0.666, P < .001). In only 17% of patients, CI did not increase after fluid loading.CONCLUSIONS: Prediction of fluid responsiveness is difficult using physical examination, CVP, ScvO2, PLR maneuver, or TPTD-derived variables in critically ill patients. A volume challenge test should be considered for the assessment of fluid responsiveness in critically ill patients admitted to the ICU.

KW - Aged

KW - Central Venous Pressure

KW - Critical Illness

KW - Female

KW - Fluid Therapy

KW - Hemodynamics

KW - Humans

KW - Intensive Care

KW - Intensive Care Units

KW - Leg

KW - Male

KW - Middle Aged

KW - Oxygen

KW - Physical Examination

KW - Predictive Value of Tests

KW - Prognosis

KW - Prospective Studies

KW - Statistics, Nonparametric

KW - Thermodilution

U2 - 10.1016/j.jcrc.2012.10.008

DO - 10.1016/j.jcrc.2012.10.008

M3 - SCORING: Journal article

C2 - 23142517

VL - 28

SP - 537.e1-9

JO - J CRIT CARE

JF - J CRIT CARE

SN - 0883-9441

IS - 4

ER -