We know that you can use echocardiography to guide fluid management, but what should or could you use?
Static echo parameters
- Predictors of fluid responsiveness
- IVC collapse (beware of full hepatic vessels), but cannot be used in 20% Basic Echo
- Left Ventricular Systolic Exclusion (the kissing ventricle) Basic Echo
- Left Ventricular End Diastolic Area <5cm2/m2
- Aortic VTI may show responsiveness, and mitral inflow tolerance
Dynamic echo parameters
- Passive leg raises (test it, take it back). Really good evidence
- Aortic ΔVmax has the best sensitivity, but ΔSVC the best specificity (and alas a TOE measurement)
Just a few things to think about. But the best thing about this course has to be the level of detailed explanations coupled with great videos and lots of clinical cases. Which ESICM Postgraduate course will you be attending in Vienna?