Thanks so much @avkwong and @Manu_Malbrain for their concise and powerful talks on the dangers of fluid overload (or better named fluid accumulation syndrome) - associated with death, affecting every organ system. #IFAD2021#FOAMed#FOAMcc
Infographic via @hughgifford
Keep in mind the deleterious effects of fluid overload and fluid accumulation syndrome on cardiovascular function #IFAD2021 via @Manu_Malbrain @azJanPalfijn
Keep in mind the deleterious effects of fluid overload and fluid accumulation syndrome on renal function #IFAD2021 via @Manu_Malbrain@azJanPalfijn
Must read for every-one guidance from China on #COVID19#COVID19BE diagnosis management and treatment from Prof. Tingbo LIANG Editor-in-Chief : how to screen for suspected COVID
Must read for every-one guidance from China on #COVID19#COVID19BE diagnosis management and treatment from Prof. Tingbo LIANG Editor-in-Chief : Protection
Must read for every-one guidance from China on #COVID19#COVID19BE diagnosis management and treatment from Prof. Tingbo LIANG Editor-in-Chief : Donning of PPE
@jasonvanschoor@UZBrussel 1/ Don’t use HFOV or NIV too much 2/ if saturation less than 95 or paO2/FiO2 less than 200 with/without RR higher than 25-30 breaths/min at FiO2 60% with CPAP by NIV (helmet preferred) after 15-30 min - intubate immediately
@jasonvanschoor@UZBrussel 3/ low tidal volume 4-6 ml/kg PBW with minimal RR to achieve pH above 7.2 4/ PEEP relatively high 13-15 cmh2O;
The question is: How to achieve the right balance
not too much
not too little
just enough
excellent talk by #NateShapiro #ISICEM19
How do we currently assess therapeutic response to fluids #ISICEM19
interesting mortality prediction model presented by #NateShapiro looking at a fluid propensity model predicting when we need to give more or less fluids
Bottom line: mortality increases with too little or too much fluids #ISICEM19
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
-...
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