Twitter
3

Given that the CVP emperor now provably has no clothes, and there are a multitude of devices measuring continuous cardiac output and various other parameters that might be used to guide intra-operative fluid management — and let's not forget the trans-esophogeal echo — has there been any demonstrable benefit of one modality over another?

I am particularly interested in how these compare to the readily measured systolic pressure variation and pulse pressure variation, which are becoming an increasingly common (and easy!) way of guiding intraoperative fluid management.

Any comparative evidence, especially evidence focusing on outcome data?

flag

2 Answers

1

SOME OF THE UPCOMMING PARAMETERS ARE - Ultrasound of Inferior venacal diameter and respiratory variation of IVC. CVP will be 5 or less if there is more than 50% variability during respiration. IVC diameter normal adult is 2.25 if less then think of hypovolemia confirm with respiratory collapse AND VARIABILITY.

ECHO VTI with resp variation and - total no increase (VTI=velocity time integral )

PLR (passive leg rising) and blood pressure changes

USG internal jugular visualisation and there upper limit

what abt cardi Q (trans esophageal doppler) corrected time value

TEE promising

Flow based monitors are much more better than pressure monitors .in my opinion CVP will be a thing of past in near future .

Emergency department bedside ultrasonographic measurement of the caval index for noninvasive determination of low central venous pressure. Nagdev AD, Merchant RC, Tirado-Gonzalez A, Sisson CA, Murphy MC. Ann Emerg Med. 2010 Mar;55(3):290-5. Epub 2009 Jun 25.

Respiratory variations of aortic VTI: a new index of hypovolemia and fluid responsiveness American Journal of Emergency Medicine Michel Slama1, Henri Masson1, Jean-Louis Teboul2, Marie-Luce Arnout1, Dinko Susic3, Edward Frohlich3, and Michel Andrejak1- Volume 27, Issue 1 (January 2009) DOI: 10.1016/j.ajem.2008.01.002

link|flag
0

so usg ivc diameter, ECHO VTI,(plr) passive leg rising test, usg internal jugular vein are some of the non invasive methods on the horizone

link|flag

Your Answer

Not the answer you're looking for? Browse other questions tagged or ask your own question.