Assessment of volume status and fluid responsiveness in the emergency department: a systematic approach

作者：Maurer C; Wagner J Y; Schmid R M; Saugel B^*

来源：Medizinische Klinik-Intensivmedizin und Notfallmedizin, 2017, 112(4): 326-333.

DOI：10.1007/s00063-015-0124-x

• Shock
• Sepsis
• Volume therapy
• Fluid deficiency
• Passive leg raising
• Fluid challenge
• Advanced hemodynamic monitoring
• Noninvasive cardiac output

When treating acutely ill patients in the emergency department (ED), the successful management of a variety of medical conditions, such as sepsis, acute kidney injury, and pancreatitis, is highly dependent on the correct assessment and optimization of a patient's intravascular volume status. Therefore, it is crucial that the ED physician knows and uses available means to assess intravascular volume status to adequately guide fluid therapy. This review focuses on techniques for volume status assessment that are available in the ED including basic clinical and laboratory findings, apparatus-based tests such as sonography and chest x-ray, and functional tests to evaluate fluid responsiveness. Furthermore, we provide an outlook on promising innovative, noninvasive technologies that might be used for advanced hemodynamic monitoring in the ED.

• 出版日期2017-5