1277: Assessing Fluid Responsiveness in Cardiogenic Shock: ETCO2, Pv-aCO2 Gap Are the Most Useful

Assessing fluid responsiveness during open chest conditions.

BACKGROUND Measurement of ventilation-induced left ventricular stroke volume variations (SVV) or pulse pressure variations (PPV) is useful to optimize preload in patients after cardiac surgery. The aim of this study was to investigate the ability of SVV and PPV measured by arterial pulse contour analysis to assess fluid responsiveness in patients undergoing coronary artery bypass surgery during...

Cardiogenic shock.

The syndrome of cardiogenic shock (CS) comprises a constellation of symptoms and signs that define a subset of patients with inadequate tissue perfusion secondary to myocardial dysfunction. Careful attention to and rapid identification of patients at risk for the development of CS and those with impending CS by both hospitalists and subspecialists will help to implement the time-sensitive thera...

Cardiogenic Shock

Assessing volume status and fluid responsiveness in the emergency department

Resuscitation with intravenous fluid can restore intravascular volume and improve stroke volume. However, in unstable patients, approximately 50% of fluid boluses fail to improve cardiac output as intended. Increasing evidence suggests that excess fluid may worsen patient outcomes. Clinical examination and vital signs are unreliable predictors of the response to a fluid challenge. We review the...

Cardiogenic shock.

Cardiogenic shock is the most common cause of death in patients hospitalized with acute myocardial infarction and is associated with a poor prognosis. More than 75% of cases are due to extensive left ventricular infarction and ventricular failure. Other causes include right ventricular infarction and papillary muscle rupture with acute severe mitral regurgitation. Activation of neurohormonal sy...