[bluesky]

Originally Posted by gradcare

I'm guessing like most other posters that the ABG was part of the puzzle. It is very difficult to claim that a patient needs more fluid on the basis of a single factor. Most experienced crit care nurses can read the monitor and gain insight into the patient's fluid state and needs by putting together all the information that is generally available on site from the monitor eg Hr BP BP waveform (resp swing) CVP etc. ?Perhaps the ABG was just the icing on the cake?

What's "resp swing"?

Thanks!

[JohnW]

Originally Posted by bluesky

What's "resp swing"?

Thanks!

I'm assuming the poster was referring to resp variation in the CVP waveform - not in the A-line tracing?

[gradcare]

No I am refering to the change in a line tracing on inspiration for the ventilated patient. Increased thoracic pressure increases afterload and decreases preload resulting in reduced stroke volume in patients who are vascularly dry. This is similar to the stroke volume variance via PICCO etc though unlike the SVV there is no objective measure. CVP may swing however the changes in pressure will be so small that it would be difficult to see from the end of the bed. Again however it is difficult to make the call whether someone is vascularly dry and requires more fluids based on a single piece of data.