The use of Guyton’s approach to the control of cardiac output for clinical fluid management
Abstract Infusion of fluids is one of the most common medical acts when resuscitating critically ill patients. However, fluids most often are given without consideration of how fluid infusion can actually improve tissue perfusion. Arthur Guyton’s analysis of the circulation was based on how cardiac...
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SpringerOpen
2024-07-01
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| Series: | Annals of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s13613-024-01316-z |
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| author | Sheldon Magder |
| author_facet | Sheldon Magder |
| author_sort | Sheldon Magder |
| collection | DOAJ |
| description | Abstract Infusion of fluids is one of the most common medical acts when resuscitating critically ill patients. However, fluids most often are given without consideration of how fluid infusion can actually improve tissue perfusion. Arthur Guyton’s analysis of the circulation was based on how cardiac output is determined by the interaction of the factors determining the return of blood to the heart, i.e. venous return, and the factors that determine the output from the heart, i.e. pump function. His theoretical approach can be used to understand what fluids can and cannot do. In his graphical analysis, right atrial pressure (RAP) is at the center of this interaction and thus indicates the status of these two functions. Accordingly, trends in RAP and cardiac output (or a surrogate of cardiac output) can provide important guides for the cause of a hemodynamic deterioration, the potential role of fluids, the limits of their use, and when the fluid is given, the response to therapeutic interventions. Use of the trends in these values provide a physiologically grounded approach to clinical fluid management. |
| format | Article |
| id | doaj-art-ae3bbda447304878839c039c0c138c35 |
| institution | Kabale University |
| issn | 2110-5820 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj-art-ae3bbda447304878839c039c0c138c352025-01-05T12:46:01ZengSpringerOpenAnnals of Intensive Care2110-58202024-07-011411610.1186/s13613-024-01316-zThe use of Guyton’s approach to the control of cardiac output for clinical fluid managementSheldon Magder0McGill University Health CentreAbstract Infusion of fluids is one of the most common medical acts when resuscitating critically ill patients. However, fluids most often are given without consideration of how fluid infusion can actually improve tissue perfusion. Arthur Guyton’s analysis of the circulation was based on how cardiac output is determined by the interaction of the factors determining the return of blood to the heart, i.e. venous return, and the factors that determine the output from the heart, i.e. pump function. His theoretical approach can be used to understand what fluids can and cannot do. In his graphical analysis, right atrial pressure (RAP) is at the center of this interaction and thus indicates the status of these two functions. Accordingly, trends in RAP and cardiac output (or a surrogate of cardiac output) can provide important guides for the cause of a hemodynamic deterioration, the potential role of fluids, the limits of their use, and when the fluid is given, the response to therapeutic interventions. Use of the trends in these values provide a physiologically grounded approach to clinical fluid management.https://doi.org/10.1186/s13613-024-01316-zVascular volumeStressed volumeVenous returnRight ventricleMeans systemic filling pressureRight atrial pressure |
| spellingShingle | Sheldon Magder The use of Guyton’s approach to the control of cardiac output for clinical fluid management Annals of Intensive Care Vascular volume Stressed volume Venous return Right ventricle Means systemic filling pressure Right atrial pressure |
| title | The use of Guyton’s approach to the control of cardiac output for clinical fluid management |
| title_full | The use of Guyton’s approach to the control of cardiac output for clinical fluid management |
| title_fullStr | The use of Guyton’s approach to the control of cardiac output for clinical fluid management |
| title_full_unstemmed | The use of Guyton’s approach to the control of cardiac output for clinical fluid management |
| title_short | The use of Guyton’s approach to the control of cardiac output for clinical fluid management |
| title_sort | use of guyton s approach to the control of cardiac output for clinical fluid management |
| topic | Vascular volume Stressed volume Venous return Right ventricle Means systemic filling pressure Right atrial pressure |
| url | https://doi.org/10.1186/s13613-024-01316-z |
| work_keys_str_mv | AT sheldonmagder theuseofguytonsapproachtothecontrolofcardiacoutputforclinicalfluidmanagement AT sheldonmagder useofguytonsapproachtothecontrolofcardiacoutputforclinicalfluidmanagement |