Theresa I dont have stroke volume optimization totally protocolized yet at this 
point but I am teaching it.  We teach our nurses in the hemodynamic class that 
stroke volume optimization is a great way to know or estimate where your 
patient is on their frank starling curve.  There are some great studies in the 
literature as well.  The algorithm I teach is that if you have a >10% change in 
your stroke volume after a fluid bolus (250 mL or 500mL over 15 minutes), or 
after a passive leg raise then your patient is on the upward portion of their 
frank starling curve.

I am developing a progress note for our physicians for the tissue 
perfusion/fluid reassessment piece. Once I have this ready for print I will be 
happy to share.   Some of the boxes for them to check will be similar to

o Stroke Volume increased with Passive Leg Raise
o Stroke Volume increased with Fluid bolus


Angela Craig APN,MS,CCNS
CNS for ICU
Cookeville Regional Medical Center
931-783-5035


________________________________
From: Sepsisgroups [[email protected]] On Behalf Of 
Posani, Theresa [[email protected]]
Sent: Thursday, September 24, 2015 11:42 AM
To: <[email protected]> ([email protected])
Subject: [Sepsis Groups] stroke volume index


Anyone using SVI with their sepsis patients regarding fluid 
resuscitation/management?
Do you have protocols that you would share?
How long or what are the stopping points to the use of SVI for fluid 
resuscitation/management?
Are you using 250, 500, or 1000 ml? and how often?
Thank you


Theresa Posani, MS, RN, ACNS-BC, CCRN
Med/Surg CNS
Sepsis Coordinator
(817) 250-3907 office
(972) 838-7954 cell
[email protected]<mailto:[email protected]>

[cid:[email protected]]A Clinical Nurse Specialist (CNS) is a 
Masters prepared Advance Practice Registered Nurse whose function is to improve 
outcomes in patient care. Functioning in five sub roles including:Expert in 
Clinical Practice, Educator, Leader, Researcher and Consultant, we influence 
our 3 spheres of practice; Patient Care, Nursing and Systems.


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