Systolic pressure variation with respiratory movement indicating fluid responsiveness.
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Hemodynamics Management
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VExUS for evaluation of venous congestion in a patient with mixed cardiogenic and distributive shock, acute respiratory failure, bibasilar infiltrates, and acute kidney injury.
Step 1: IVC diameter is 2.5 cm
Step 2: hepatic vein doppler assessment showing reversal of the systolic wave.
Step 3: Portal vein doppler assessment showing more than 50% variability
Systolic blood pressure (SBP) variation with respiratory movement on the ventilator can be used to assess fluid responsiveness in the ICU. The higher the variation above 13% the more likely to respond to fluid. Make sure the rhythm is sinus and tidal volume on the ventilator is adequate to reflect a change in the intrathoracic pressure.
Use of end-expiratory occlusion test in the assessment of volume status and fluid responsiveness: for more details please visit my recent blog at https://www.icureach.com/post/how-end-expiratory-occlusion-test-eeo-test-can-help-assess-fluid-responsiveness-in-icu-patients
IVC collapse with inspiration in a patient with hypovolemia
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Very beautiful demonstration
It helps to suggest offloading rather than fluid resuscitation
It requires stady hands and minimal pt movement (abd wise) in order to catch the image in PW mode
If my memory serves me right, there were only limited data from multiple case report
No strong data to suggest outcome
Yet a useful tool to add on for the management
If we have research, i think mortality outcome, Cr trend, O2 requirements, vasopressors doses would be excellent markers for monitoring
Thank you Dr Mazen for your amazing continuous contribution to enriching our knowledge