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Assessing fluid responsiveness: the role of dynamic haemodynamic indices

Department of Anaesthetics, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK, ari.ercole{at}doctors.org.uk

Intravenous fluid infusion is a simple way of improving cardiac output and oxygen delivery in shock. However, the consequences of fluid overload can be serious. Direct measurement of cardiac output after fluid administration may not always be feasible and simple measures of arterial or central venous pressure are poor indicators of hypovolaemia and fluid responsiveness. Measures based on the change in these parameters with variation in preload such as occurs during the respiratory cycle are more powerful predictors of the cardiovascular response to filling as they relate to the shape of the cardiac output performance curve. In this article, we describe the origin, interpretation and limitations of such dynamic indices.

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