Dynamic fluid response By Momen Ali Khan

Definition

Dynamically determination of shock status by the cardiovascular response ( heart rate, blood pressure, CVP) by rapid administration of fluid bolus.

Rapid administration

Rapid administration of fluid bolus means administration 0f 250 to 500 ml fluid over 5 to 10 minute.

Patient condition

After rapid administration of fluid patient can divide into-

Responders Transient respondersNon-responders

Responders Improvement in patient cardiovascular status which is sustained.

Significance These patients are not actively losingfluid but require filling to a normal volume status.

Transient responders

Have an improvement which then reverts to the previous state over the next 10–20 minutes.

SignificanceThese patients have moderate ongoing fluid losses (either overt haemorrhage or further fluid shifts reducing intravascular volume).

Non-responders

Are severely volume depleted and are likely to have major ongoing loss of intravascular volume, usually through persistent uncontrolled haemorrhage.

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