Ultrasound imaging of vena caval diameter fluctuation with respiration is a safe, noninvasive method to assess fluid responsiveness in apneic patients on controlled mechanical ventilation. Two-thirds of patients will not be fluid responsive following an initial volume resuscitation of 30 ml/kg. In spontaneously breathing patients the degree of IVC fluctuation is a function of both respiratory effort and the pressure applied to assist ventilation, and without standardized ventilator settings it has not been proven a reliable indicator of fluid responsiveness.

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Que tal olharmos a via de saída ao invés da Veia cava?

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Early dynamic left intraventricular obstruction is associated with hypovolemia and high mortality in septic shock patients

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http://ccforum.biomedcentral.com/articles/10.1186/s13054-015-0980-z

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Conclusion

Left IVO is a frequent event in septic shock patients with an important correlation with fluid responsiveness. The mortality rate was found to be higher in these patients in comparison with patients without obstruction.

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Quando o coração bate “seco”, como nas fotos acima, dá vontade de assumir a prescrição do paciente na UTI e dizer:

Está na hora de infundir volume!!!

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