[Assessment of volume responsiveness in mechanically ventilated XXXX ].

@entity1 @entity32 @entity64 @entity296 @entity712 @entity548 @entity3126 @entity3124 @entity1503 @entity3485 @entity299 @entity551
Monitoring and management of intravascular volume status is of crucial importance in @entity3124 @entity1 . @entity3485 , induced by @entity548 or pathologic fluid shifts in the presence of systemic @entity32 , is frequently the cause for hemodynamic instability and @entity551 . This @entity1503 leads to a reduction in biventricular cardiac preload. With respect to the Frank-Starling mechanism, this causes an alteration in left @entity64 . If this reduction in @entity64 volume cannot be compensated by an increase in heart rate, this finally results in a decline of cardiac output. In this clinical situation fluid loading is the treatment of choice. However, insufficient peripheral vascular resistance and thus reduced cardiac afterload as well as @entity296 also have to be taken in account to be causative for @entity551 . Potential hazards of fluid loading specifically in the latter situation include @entity3126 , worsening of pulmonary gas exchange and @entity712 . Thus, prediction of fluid responsiveness, i.e. the prediction of the hemodynamic response to fluid loading is of utmost importance in @entity3124 @entity1 . Several conventional parameters of systemic hemodynamic monitoring such as the @entity299 and PAOP, the estimation of the left ventricular end-diastolic area (LVEDA) by echocardiography and measurement of central blood volumes as the right-ventricular end-diastolic volume (RVEDV) or the global end-diastolic volume (GEDV) by thermodilution are frequently used for preload monitoring. Further, functional preload parameters such as the left @entity64 (SW), describing the specific interactions of the heart and the lungs under mechanical ventilation, have been recently proposed to be useful for predicting fluid responsiveness. Thus, it is the aim of the present article to analyze these different concepts of hemodynamic monitoring regarding their usefulness and clinical applicability to predict fluid responsiveness at the bedside.
