Thursday, August 13, 2020

Static and Dynamic parameters of fluid responsiveness

Q: What are the static and dynamic parameters of hemodynamic?

Answer: The monitoring of hemodynamic can have two parameters, either static or dynamic. 

Static parameters get measured periodically like cuff Mean Arterial Pressure (MAP), Central Venous Pressure (CVP), and Mixed or Mixed central Venous oxygenation (SVo2 or ScvO2). 

Dynamic parameters include respiratory changes in the vena caval diameter, radial artery pulse pressure, aortic blood flow peak velocity, left ventricular outflow tract velocity-time integral, and brachial artery blood flow velocity. Dynamic parameters are more reliable predictors of fluid responsiveness given a patient is in normal sinus rhythm and passively ventilated. In actively breathing patients or those with irregular cardiac rhythms, a passive leg-raising maneuver is another excellent dynamic parameter to predict fluid responsiveness.



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2. Michard F, Lopes MR, Auler JO Jr. Pulse pressure variation: beyond the fluid management of patients with shock. Crit Care 2007; 11:131. 

3. Mandeville JC, Colebourn CL. Can transthoracic echocardiography be used to predict fluid responsiveness in the critically ill patient? A systematic review. Crit Care Res Pract 2012; 2012:513480. 

4.  Marik PE, Monnet X, Teboul JL. Hemodynamic parameters to guide fluid therapy. Ann Intensive Care 2011; 1:1.

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