Extensive literature describes the suitability of dynamic parameters to predict responsiveness in fluid. However, based on heart-lung interactions, these parameters can have serious limitations, including the use of protective lung ventilation. Although the latter seems to be beneficial for healthy patients undergoing high-risk surgery, the intraoperative interpretation of dynamic parameters to predict fluid responsiveness can be hazardous. In this context, the attending physician could, alternatively, titrate the need of fluids with a small fluid challenge, which remains unaffected by low tidal volume, the presence of arrhythmia, or the presence of spontaneous ventilation. When intraoperative prediction of fluid responsiveness is required in mechanically ventilated patients, "improved" titration should be preferred to a hypothetical prediction.
Keyphrases
- patients undergoing
- end stage renal disease
- heart failure
- systematic review
- ejection fraction
- emergency department
- minimally invasive
- primary care
- chronic kidney disease
- atrial fibrillation
- prognostic factors
- coronary artery bypass
- acute respiratory distress syndrome
- patient reported outcomes
- coronary artery disease
- acute coronary syndrome
- patient reported