BACKGROUND: Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients. The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes (such as acute pulmonary edema necessitating endotracheal intubation). We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefit from volume resuscitation. DATA RESOURCES: We performed a search using PubMed, Scopus, and MEDLINE. The following search terms were used: fluid responsiveness, ultrasound, non-invasive, hemodynamic, fluid challenge, and passive leg raise. Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient's cardiovascular ability to respond to intravenous fluid administration using ultrasound. RESULTS: Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava, common carotid artery, subclavian vein, internal jugular vein, and femoral vein. Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients. CONCLUSION: Ultrasound in combination with passive leg raise is a non-invasive, cost- and time-effective modality that can be employed to assess volume status and response to fluid resuscitation. Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava, and internal jugular vein. A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.
BACKGROUND: Volume resuscitation has only been demonstrated to be effective in approximately fifty percent of patients. The remaining patients do not respond to volume resuscitation and may even develop adverse outcomes (such as acute pulmonary edema necessitating endotracheal intubation). We believe that point-of-care ultrasound is an excellent modality by which to adequately predict which patients may benefit from volume resuscitation. DATA RESOURCES: We performed a search using PubMed, Scopus, and MEDLINE. The following search terms were used: fluid responsiveness, ultrasound, non-invasive, hemodynamic, fluid challenge, and passive leg raise. Preference was given to clinical trials and review articles that were most relevant to the topic of assessing a patient's cardiovascular ability to respond to intravenous fluid administration using ultrasound. RESULTS: Point-of-care ultrasound can be easily employed to measure the diameter and collapsibility of various large vessels including the inferior vena cava, common carotid artery, subclavian vein, internal jugular vein, and femoral vein. Such parameters are closely related to dynamic measures of fluid responsiveness and can be used by providers to help guide fluid resuscitation in critically ill patients. CONCLUSION: Ultrasound in combination with passive leg raise is a non-invasive, cost- and time-effective modality that can be employed to assess volume status and response to fluid resuscitation. Traditionally sonographic studies have focused on the evaluation of large veins such as the inferior vena cava, and internal jugular vein. A number of recently published studies also demonstrate the usefulness of evaluating large arteries to predict volume status.
Authors: N Kelly; R Esteve; T J Papadimos; R P Sharpe; S A Keeney; R DeQuevedo; M Portner; D P Bahner; S P Stawicki Journal: Eur J Trauma Emerg Surg Date: 2015-01-08 Impact factor: 3.693
Authors: Xavier Monnet; Mario Rienzo; David Osman; Nadia Anguel; Christian Richard; Michael R Pinsky; Jean-Louis Teboul Journal: Crit Care Med Date: 2006-05 Impact factor: 7.598
Authors: Alistair Kent; Prabhav Patil; Victor Davila; J Kevin Bailey; Christian Jones; David C Evans; Creagh T Boulger; Eric Adkins; Jayaraj M Balakrishnan; Sebastian Valiyaveedan; Sagar C Galwankar; David P Bahner; Stanislaw P Stawicki Journal: Ann Thorac Med Date: 2015 Jan-Mar Impact factor: 2.219
Authors: Javier A Neyra; Joshua Lambert; Victor Ortiz-Soriano; Daniel Cleland; Jon Colquitt; Paul Adams; Brittany D Bissell; Lili Chan; Girish N Nadkarni; Ashita Tolwani; Stuart L Goldstein Journal: PLoS One Date: 2022-08-25 Impact factor: 3.752