Dr J : CVP is another useful measurement........regardeless of your opinion which I do not agree What I do agree is that passive leg raising is very helpfull, the most important is that one should use all the tools available
Regards From my HTC Sensation 4G on T-Mobile. The first nationwide 4G network ----- Reply message ----- De: "Jo Krewinkel" <[email protected]> Para: <[email protected]>, "[email protected]" <[email protected]>, <[email protected]> CC: <[email protected]> Asunto: Betr.: Re: [Sepsis Groups] volume required Fecha: vie., feb. 15, 2013 4:37 a. m. +=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=* Antwoord gewenst Bij gelegenheid+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=* Why don't you use Passive Leg Rising to see if a patient is fluid responsive, easy to use without any complication of overfilling and we all know that CVP is not the right measurement to see if fluid works. So please stop using this as a measurement for fluid-responsiviness J Krewinkel RN ICU, circulation Practitioner Atrium MC Parkstad the Netherlands Met vriendelijke groet,J. KrewinkelCirculation PractitionerAtrium MC Parkstad [email protected] 045-5767010 >>> [email protected]<[email protected]> 2/12/2013 3:17 >>>Fluid >>> challenge is one of the most dificult things to do....sometimes you just >>> need 1 l of cristaloids on others you will use as much as 5 l.....as it was >>> mentioned above the clinical response is the goal....o others you will need >>> more tools like central venous pressure, svo2 Even measure the diameter of >>> inferior cava vein all these to estimate where are you standing.....Hope it >>> helpsJuan pataro mdinstituto argentino de riñon y transplanteFrom my HTC >>> Sensation 4G on T-Mobile. The first nationwide 4G network ----- Reply message -----De: "Rich Levrault" <[email protected]>Para: "sandeep varma" <[email protected]>CC: "[email protected]" <[email protected]>Asunto: [Sepsis Groups] volume requiredFecha: dom., feb. 10, 2013 10:59 a. m. Fluid should be given until it fails to produce a clinically appropriate response. Pulmonary edema is sometimes a necessary evil. Sent from Rich's iPhone On Feb 9, 2013, at 1:15 AM, sandeep varma <[email protected]> wrote: hello all i have a query regarding fluid volume requirement in sepsis. often have seen blood pressure improvement after fluid bolus but only to see it fall back after few minutes. the postulated theory behind this was leakage of given fluid into interstitial causing intravascular depletion again. my concern is that how much of fluid can be given this way? will this lead on to pulmonary edema and interstitial edema without much helping in building up intra vascular volume and aiding in stabilizing blood pressure? sandeep varma thriuvananthapuram kerala india _______________________________________________Sepsisgroups mailing [email protected]http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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