Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation

Introduction. Circulatory failure secondary to hypovolemia is a common situation in critical care patients. Volume replacement is the first option for the treatment of hypovolemia. A possible complication of volume loading is pulmonary edema, quantified at the bedside by the measurement of extravasc...

Full description

Saved in:
Bibliographic Details
Main Authors: Carlos Ferrando, Gerardo Aguilar, F. Javier Belda
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/437659
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849304480967819264
author Carlos Ferrando
Gerardo Aguilar
F. Javier Belda
author_facet Carlos Ferrando
Gerardo Aguilar
F. Javier Belda
author_sort Carlos Ferrando
collection DOAJ
description Introduction. Circulatory failure secondary to hypovolemia is a common situation in critical care patients. Volume replacement is the first option for the treatment of hypovolemia. A possible complication of volume loading is pulmonary edema, quantified at the bedside by the measurement of extravascular lung water index (ELWI). ELWI predicts progression to acute lung injury (ALI) in patients with risk factors for developing it. The aim of this study was to assess whether fluid loading guided by the stroke volume variation (SVV), in patients presumed to be hypovolemic, increased ELWI or not. Methods. Prospective study of 17 consecutive postoperative, fully mechanically ventilated patients diagnosed with circulatory failure secondary to presumed hypovolemia were included. Cardiac index (CI), ELWI, SVV, and global end-diastolic volume index (GEDI) were determined using the transpulmonary thermodilution technique during the first 12 hours after fluid loading. Volume replacement was done with a strict hemodynamic protocol. Results. Fluid loading produced a significant increase in CI and a decrease in SVV. ELWI did not increase. No correlation was found between the amount of fluids administered and the change in ELWI. Conclusion. Fluid loading guided by SVV in hypovolemic and fully mechanically ventilated patients in sinus rhythm does not increase ELWI.
format Article
id doaj-art-103cdb78579249b59b2cacfbb5acd71c
institution Kabale University
issn 2090-1305
2090-1313
language English
publishDate 2012-01-01
publisher Wiley
record_format Article
series Critical Care Research and Practice
spelling doaj-art-103cdb78579249b59b2cacfbb5acd71c2025-08-20T03:55:44ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/437659437659Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume VariationCarlos Ferrando0Gerardo Aguilar1F. Javier Belda2Department of Anesthesiology and Critical Care, Hospital Clínico Universitario de Valencia, 46010 Valencia, SpainDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario de Valencia, 46010 Valencia, SpainDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario de Valencia, 46010 Valencia, SpainIntroduction. Circulatory failure secondary to hypovolemia is a common situation in critical care patients. Volume replacement is the first option for the treatment of hypovolemia. A possible complication of volume loading is pulmonary edema, quantified at the bedside by the measurement of extravascular lung water index (ELWI). ELWI predicts progression to acute lung injury (ALI) in patients with risk factors for developing it. The aim of this study was to assess whether fluid loading guided by the stroke volume variation (SVV), in patients presumed to be hypovolemic, increased ELWI or not. Methods. Prospective study of 17 consecutive postoperative, fully mechanically ventilated patients diagnosed with circulatory failure secondary to presumed hypovolemia were included. Cardiac index (CI), ELWI, SVV, and global end-diastolic volume index (GEDI) were determined using the transpulmonary thermodilution technique during the first 12 hours after fluid loading. Volume replacement was done with a strict hemodynamic protocol. Results. Fluid loading produced a significant increase in CI and a decrease in SVV. ELWI did not increase. No correlation was found between the amount of fluids administered and the change in ELWI. Conclusion. Fluid loading guided by SVV in hypovolemic and fully mechanically ventilated patients in sinus rhythm does not increase ELWI.http://dx.doi.org/10.1155/2012/437659
spellingShingle Carlos Ferrando
Gerardo Aguilar
F. Javier Belda
Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation
Critical Care Research and Practice
title Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation
title_full Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation
title_fullStr Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation
title_full_unstemmed Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation
title_short Extravascular Lung Water Does Not Increase in Hypovolemic Patients after a Fluid-Loading Protocol Guided by the Stroke Volume Variation
title_sort extravascular lung water does not increase in hypovolemic patients after a fluid loading protocol guided by the stroke volume variation
url http://dx.doi.org/10.1155/2012/437659
work_keys_str_mv AT carlosferrando extravascularlungwaterdoesnotincreaseinhypovolemicpatientsafterafluidloadingprotocolguidedbythestrokevolumevariation
AT gerardoaguilar extravascularlungwaterdoesnotincreaseinhypovolemicpatientsafterafluidloadingprotocolguidedbythestrokevolumevariation
AT fjavierbelda extravascularlungwaterdoesnotincreaseinhypovolemicpatientsafterafluidloadingprotocolguidedbythestrokevolumevariation