Mallemat: The Art and Science of Fluid Responsiveness

Leggé del

CuoreMaestrini

DarioMaestrini

NormalContraction

Increased!Contractility

Frank Starling

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Decrease Inotropy

Increased Inotropy

…but not !one drop!more!”

…give all !the fluid !

they need…“

Fluid Responsive

Static Dynamic

Static Dynamic

Invasive

Steve Waugh

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Deficit or Excess Blood Volume

CVP!mmHg

Non-Invasive

?

IVC ~ CVP

Static

Positive Pressure Release

P!P!V

ulseressureariation

ExpirationInspiration

Maximum - Minimum Average

13%

13%>

Sinus

8cc/kg

Synchrony

PEEPRV

Abdominal Pressure

Distensibility!Index

Positive Pressure Release

Expiration

Inspiration

Distensibility Index

Maximum - Minimum Average

12%

Distensibility IndexMaximum - Minimum

Minimum

18%

84%

4%

Sub-Aortic!Peak!Velocity

Maximum - Minimum Average

12%

27%

9%

17%

Expiratory Occlusion Test

Passive Leg

Raise

SV

LVOT!

Diameter

Stroke Distance

Velocity Time Integral

3.14 x r2 x VTI

SV

%12

Dynamic

Art Science&

Thank you@criticalcarenow

haney.mallemat@gmail.com