Thread by @Fluid_Academy

Assessment of Fluid Overload and Hypervolemia (1/8)

Clinical assessment and signs for #FO are aspecific and unreliable:
-pitting edema
-ascites
-positive fluid balance
-orthopnea
-hepatojugular reflux
-...

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019

Assessment of Fluid Overload and Hypervolemia (2/8)

Biochemical Assessment for #FO is aspecific and unreliable:
-Hypoalbuminemia
-Hypoproteinemia
-low COP
-low osmolality
-...

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019

Assessment of Fluid Overload (FO) and Hypervolemia (3/8)

Radiological and #POCUS imaging and signs for #FO are aspecific and unreliable:
- Absence of #IVCC
- Kerley-B lines
- Lung ultrasound B-lines
- Pleural effusions

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019

Assessment of Fluid Overload (#FO) and Hypervolemia (4/8)

Ten situations where #IVCC may fail to accurately predict fluid responsiveness
link.springer.com/article/10.100…
- high PEEP
- tamponade
- autoPEEP
- increased #IAP
- etc...

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019

Assessment of Fluid Overload (#FO) and Hypervolemia (5/8)

Hemodynamic assessment for signs and symptoms of #FO are:
- negative PLR, EEO test
- absence of fluid responsiveness
- low PPV
- high volumetric preload (GEDVI)

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019

Assessment of Fluid Overload (#FO) and Hypervolemia (6/8)

Organ function assessment for signs and symptoms of #FO are:
- high EVLWI and PVPI
- increased ICP and IAP
- gastric distention - ileus
- oliguria

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019

@ISICEM

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