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Fluid Responsiveness

The following algorithm can be used to guide fluid resuscitation using cardiac ultrasound.

Start FR Alg

Do you see the following features on your FoCUS exam?

Hyperdynamic LV

LV ED area <10cm2

SAM

IVC<1cm

Signs of overt hypovolemia (anyone of the following images is considered to be fluid responsive ):

Give Fluid Challenge

Measure VTI or SV before and immediately after 250ml bolus bolus challenge if clinically indicated. Fluid responsive does not mean they need fluid but that they should respond by increasing cardiac output.

FS curve.png

You are probably on the steep portion of the FS curve (above)

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Fluid Given?

 

First Fluid Callenge

Did you observe an increase of the VTI or SV of 15% or more compared to baseline?

Testing