Core EM - By tim Gallagher
and Lung Ultrasound (J Crit Care, 2015)
"Background
In critically ill patients, fluid status is a balancing act. Too little fluid resuscitation can lead to end organ hypoperfusion, while too much fluid resuscitation can lead to pulmonary edema and respiratory compromise. In some situations, it is difficult to differentiate who will benefit from more fluids and who will be fluid unresponsive or even require fluid restriction.
This article put forth two goals:
- Review of current literature on Point of Care Ultrasound (POCUS) of IVC and Lungs to assess fluid status
- To create an algorithm, based on POCUS of IVC and lung fields to sort patients into 3 categories: fluid resuscitate, fluid test, fluid restrict
Bottom Line
Based on the existing literature, this algorithm creates a reasonable approach to assessing volume status and volume responsiveness in patients. As with any algorithm, it should be integrated into the entire clinical picture."
http://coreem.net/journal-reviews/us-guided-fluid-assessment/