Bedside General and Cardiac Ultrasonography in the Evaluation of Critically Ill Patients: Part II
Publication Date: June 1, 2016
Last Updated: March 14, 2022
Recommendations
Preload Responsiveness
In Mechanically Ventilated Patients About to Undergo Fluid Resuscitation (Recommended for All Levels of Training).
We recommend critical care practitioners consider measuring IVC collapsibility in patients on positive pressure ventilation by bedside cardiac ultrasound (BCU) to assess fluid responsiveness prior to undergoing large volume fluid resuscitation. Any patient who has more than 15% change in vena caval diameter should be considered preload responsive. Patients with a smaller change in IVC diameter may not respond favorably to fluid resuscitation. (1B)
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In Spontaneously Breathing Patients About to Undergo Fluid Resuscitation
- We make no recommendation regarding the method of assessment of fluid responsiveness either by IVC diameter and collapsibility or other methods to assist with shock resuscitation of the spontaneously breathing patient.
- We make no recommendation regarding the method of assessment of fluid responsiveness in those with abdominal compartment syndrome.
In Patients Unable to Obtain Adequate Images With TTE (Recommended for Expert Levels of Training)
We recommend that TEE presents a reliable, low-risk, and timely solution to help the practitioner evaluate a patient’s preload responsiveness when TTE cannot be performed. (1C)
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Title
Bedside General and Cardiac Ultrasonography in the Evaluation of Critically Ill Patients: Part II
Authoring Organization
Society of Critical Care Medicine