Volume responsive, but does the patient need volume?

Commentary: Does patient volume matter for low-risk deliveries?

That there is a volume-outcome relationship for deliveries, and that mortality is lower for births that occur in hospitals with higher level neonatal intensive care units (NICU) is well established. Numerous studies have found this relationship for all births, 1–4 or selected groups of higher risk cases. 5–8 Using all births in the German State of Hesse for a 10-year period, the study by Heller...

Hospital percutaneous coronary intervention volume and patient mortality, 1998 to 2000: does the evidence support current procedure volume minimums?

OBJECTIVES The aim of this study was to evaluate current American College of Cardiology/American Heart Association (ACC/AHA) hospital percutaneous coronary intervention (PCI) volume minimum recommendations. BACKGROUND In order to reduce procedure-associated mortality, ACC/AHA guidelines recommend that hospitals offering PCIs perform at least 400 PCIs annually. It is unclear whether this volum...

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A surgeon's case volume of oesophagectomy for cancer does not influence patient outcome in a high volume hospital.

The aim of this study is to assess if individual case volume of oesophageal resections influences the operative mortality rate in a high volume hospital. Between June 1994 and June 2006, 252 total thoracic oesophageal resections (75% male, mean age 63 years) were performed by five surgeons in tertiary referral centre. Operative approach was standardised in all cases and consisted of left thorac...

Stroke volume and passive leg raising predict volume responsiveness in ICU patients: who is actually responsive?

First, we wonder why the authors chose to enroll only the patients who were a priori considered to require volume expansion. Especially with the use of a non-invasive technique and the PLR being part of routine practice, it would be very instructive to know which and how many patients from the general ICU population are actually fluid responsive or likely to be exposed to excess fluid administr...