Do dynamic assessments of fluid responsiveness reduce LOS, mechanical ventilation, renal replacement therapy and improve patient safety?

In patients with septic shock, a randomized controlled trial (n=124), a retrospective cohort study (n=191), and a large, prospective, observational association study (n=700+) revealed that dynamic assessments reduce the need for mechanical ventilation and renal replacement therapy1,2, decrease ICU length of stay2 and were associated with decreased mortality3.

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Is fluid unresponsiveness common early in care?

In a study of 424 sepsis and septic shock patients, nearly 1 in 3 were fluid unresponsive following the initial crystalloid bolus1. A very similar rate of fluid unresponsiveness in the ED was observed with wearable Doppler2.

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Does testing for fluid responsiveness save you money?

In a study of 191 patients, sepsis resuscitation guided by fluid responsiveness (i.e., changing stroke volume) reduced fluid balance, duration of ICU stay, vasopressors, requirement for mechanical ventilation, and hemodialysis compared with usual care1; total cost savings were $14,498 per patient treated, or a total of $1,449,900 for the 6-month study duration2.

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Can carotid Doppler ultrasound be used to determine fluid responsiveness (i.e. changing stroke volume)?

In a prospective study of critically-ill patients with undifferentiated shock (n=77), a meta-analysis of ten studies in anesthesia and critical care (n=424), a pilot study of CABG patients (n=23) and 2 studies in healthy volunteers with moderate-to-severe central blood volume loss (n=25), carotid artery corrected flow time was observed to track changing stroke volume (i.e., […]

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