scholarly journals Hemodynamic effects of different fluid volumes for a fluid challenge in septic shock patients

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ting Yang ◽  
Li Weng ◽  
Wei Jiang ◽  
Shan Li ◽  
Bin Du
Keyword(s):  
Septic Shock ◽  
Fluid Challenge ◽  
Hemodynamic Effects

scholarly journals Right ventricular failure in septic shock: characterization, incidence and impact on fluid responsiveness

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Antoine Vieillard-Baron ◽  
Amélie Prigent ◽  
Xavier Repessé ◽  
Marine Goudelin ◽  
Gwenaël Prat ◽  
...  
Keyword(s):  
Septic Shock ◽  
Right Ventricular ◽  
Venous Pressure ◽  
Fluid Challenge ◽  
Venous Congestion ◽  
Critical Care Echocardiography ◽  
Group 3 ◽  
Potential Impact ◽  
Group 2 ◽  
Group 1

Abstract Objective Incidence of right ventricular (RV) failure in septic shock patients is not well known, and tricuspid annular plane systolic excursion (TAPSE) could be of limited value. We report the incidence of RV failure in patients with septic shock, its potential impact on the response to fluids, as well as TAPSE values. Design Ancillary study of the HEMOPRED prospective multicenter study includes patients under mechanical ventilation with circulatory failure. Setting This is a multicenter intensive care unit study Patients Two hundred and eighty-two patients with septic shock were analyzed. Patients were classified in three groups based on central venous pressure (CVP) and RV size (RV/LV end-diastolic area, EDA). In group 1, patients had no RV dilatation (RV/LVEDA < 0.6). In group 2, patients had RV dilatation (RV/LVEDA ≥ 0.6) with a CVP < 8 mmHg (no venous congestion). RV failure was defined in group 3 by RV dilatation and a CVP ≥ 8 mmHg. Pulse pressure variation (PPV) was systematically recorded. Interventions None. Measurements and main results In total, 41% of patients were in group 1, 17% in group 2 and 42% in group 3. A correlation between RV size and CVP was only observed in group 3. Higher RV size was associated with a lower response to passive leg raising for a given PPV. A large overlap of TAPSE values was observed between the 3 groups. 63.5% of patients with RV failure had a normal TAPSE. Conclusions RV failure, defined by critical care echocardiography (RV dilatation) and a surrogate of venous congestion (CVP ≥ 8 mmHg), was frequently observed in septic shock patients and negatively associated with response to a fluid challenge despite significant PPV. TAPSE was unable to discriminate patients with or without RV failure.

scholarly journals Right ventricular failure in septic shock. Characterization, incidence and impact on fluid-responsiveness

2020 ◽  
Author(s):  
Antoine Vieillard-Baron ◽  
Amélie Prigent ◽  
Xavier Repessé ◽  
Marine Goudelin ◽  
Gwenaël Prat ◽  
...  
Keyword(s):  
Septic Shock ◽  
Right Ventricular ◽  
Venous Pressure ◽  
Fluid Challenge ◽  
Venous Congestion ◽  
Critical Care Echocardiography ◽  
Group 3 ◽  
Potential Impact ◽  
Group 2 ◽  
Group 1

Abstract Objective Incidence of right ventricular (RV) failure in septic shock patients is not well-known and Tricuspid annular plane systolic excursion (TAPSE) could be of limited value. We report the incidence of RV failure in patients with septic shock, its potential impact on the response to fluids, as well as TAPSE values.Design Ancillary study of the HEMOPRED prospective multicenter study including patients under mechanical ventilation with circulatory failure.Setting Multicenter intensive care unit studyPatients 282 with septic shock were analyzed. Patients were classified in 3 groups based on central venous pressure (CVP) and RV size (RV/LV end-diastolic area, EDA). In group 1, patients had no RV dilatation (RV/LVEDA < 0.6). In group 2, patients had RV dilatation (RV/LVEDA ≥ 0.6) with a CVP < 8 mmHg (no venous congestion). RV failure was defined in group 3 by RV dilatation and a CVP ≥ 8 mmHg. Pulse pressure variation (PPV) was systematically recorded.Interventions NoneMeasurements And main results 41% of patients were in group 1, 17% in group 2 and 42% in group 3. A correlation between RV size and CVP was only observed in group 3. Higher RV size was associated with a lower response to passive leg raising for a given PPV. A large overlap of TAPSE values was observed between the 3 groups. 63.5% of patients with RV failure had anormal TAPSE.Conclusions RV failure, defined by critical care echocardiography (RV dilatation) and a surrogate of venous congestion (CVP ≥ 8 mmHg), was frequently observed in septic shock patients and negatively associated with response to a fluid challenge despite significant PPV. TAPSE was unable to discriminate patients with or without RV failure.

HEMODYNAMIC EFFECTS OF VASOPRESSIN IN THE TREATMENT OF VASODILATORY SEPTIC SHOCK

1998 ◽  
Vol 26 (Supplement) ◽  
pp. 29A
Author(s):  
Mary Beth Malay ◽  
Sherry A. Burchell ◽  
Robert C. Ashton ◽  
Jennifer L. Ashton ◽  
Donald W. Landry ◽  
...  
Keyword(s):  
Septic Shock ◽  
Hemodynamic Effects

OPTIMAL CENTRAL VENOUS PRESSURE IN FLUID CHALLENGE IN SEVERE SEPSIS AND SEPTIC SHOCK.

2005 ◽  
Vol 33 ◽  
pp. A166
Author(s):  
Bogdan N Dobrin ◽  
Giulia Soldati ◽  
Marc Van Nuffelen ◽  
Jean-Louis Vincent
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Central Venous Pressure ◽  
Venous Pressure ◽  
Fluid Challenge ◽  
Central Venous ◽  
Sepsis And Septic Shock

Comparison of volume and hemodynamic effects of crystalloid, hydroxyethyl starch, and albumin in patients undergoing major abdominal surgery: a prospective observational study

2020 ◽  
Author(s):  
Daisuke Toyoda ◽  
Yuichi Maki ◽  
Yasumasa Sakamoto ◽  
Junki Kinoshita ◽  
Risa Abe ◽  
...  
Keyword(s):  
Observational Study ◽  
Abdominal Surgery ◽  
Stroke Volume ◽  
Hydroxyethyl Starch ◽  
Fluid Challenge ◽  
Stroke Volume Index ◽  
Ringer Solution ◽  
Colloid Osmotic Pressure ◽  
Volume Index ◽  
Hemodynamic Effects

Abstract Background The volume effect of iso-oncotic colloid is supposedly larger than crystalloid, but such differences are dependent on clinical context. The purpose of this study was to compare the volume and hemodynamic effects of crystalloid and colloid during surgical manipulation in patients undergoing major abdominal surgery. Methods Subjects undergoing intraabdominal surgery for malignancies with intraoperative goal-directed fluid management enrolled in this observational study. Fluid challenges consisted with 250 ml of either bicarbonate Ringer solution, 6% hydroxyethyl starch or 5% albumin were provided to maintain optimal stroke volume index. Hematocrit derived-plasma volume and colloid osmotic pressure was determined immediately before and 30 min after the fluid challenge. Data were expressed as median (IQR) and statistically compared with Kruskal-Wallis test. Results One hundred thirty-nine fluid challenges in 65 patients were analyzed. bicarbonate Ringer solution, 6% hydroxyethyl starch and 5% albumin were administered in 42, 49 and 48 instances, respectively. Plasma volume increased 7.3 (3.6–10.0) % and 6.3 (1.4–8.8) % 30 min after the fluid challenge with 6% hydroxyethyl starch and 5% albumin and these values are significantly larger than the value with bicarbonate Ringer solution (1.0 (-2.7-2.3) %) Colloid osmotic pressure increased 0.6 (0.2–1.2) mmHg after the fluid challenge with 6% hydroxyethyl starch and 0.7(0.2–1.3) mmHg with 5% albumin but decreased 0.6 (0.2–1.2) mmHg after the fluid challenge with bicarbonate Ringer solution. The area under the curve of stroke volume index after fluid challenge was significantly larger after 6% hydroxyethyl starch or 5% albumin compared to bicarbonate Ringer solution. Conclusions Fluid challenge with 6% hydroxyethyl starch and 5% albumin showed significantly larger volume and hemodynamic effects compared to bicarbonate Ringer solution during gastrointestinal surgery. Trial registration: UMIN Clinical Trial Registry UMIN000017964. Registered July 01, 2015

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