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Year : 2019  |  Volume : 32  |  Issue : 2  |  Page : 389-396

Predictors of effective fluid therapy in the intensive care unit

1 Department of Anesthesia and ICU, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Intensive Care, Ministry of Health, Al Haram Hospital, Giza, Egypt

Correspondence Address:
Dr. Heba M Naguib
104 Al-Haram Street, Giza, Cairo 32717
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_721_17

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Objective Static and dynamic indices predicting fluid responsiveness (FR) in critically ill patients, physiological basis, advantages, disadvantages, and cut-off values for each method. Materials and methods Medical textbooks, Medscape, PubMed, and the ScienceDirect. The databases were searched from the start date of the database and a search was performed on May 2016 with no language restriction. The initial search found 25 articles of which 15 met the inclusion criteria that address preload responsiveness, FR, and cardiac output monitoring devices. Extraction was carried out depending on the validity, quality, and originality of the selected reviews and studies; and the focus was on studies that presented the latest updated findings on FR in the ICU. Each review and study was reviewed independently without intercomparisons. The layout was selected to present a big data including the most updated findings on the subject. Result Dynamic indices predicting FR in the ICU provide the best prognosis and outcome. Early detection of fluid nonresponsive patients in the ICU will help avoid fluid overload, which is an independent predictor of mortality. Conclusion Dynamic FR monitoring methods are preferable to static methods. Each dynamic method has its benefits and limitations. Inferior vena cava (IVC) sonography such as IVC collapsibility, IVC distensibillity, and delta IVC might provide a valuable tool and alternate approach for guidance of fluid therapy in spontaneously breathing and mechanically ventilated patients, respectively.

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