jamst149

Thanks for not addressing anything i posted. Be it a paper or something i said.

And what would I learn about you? Don't be passive aggressive . Enlighten me

"Passive leg raise is a way to determine fluid responsiveness. Good tool. Again...people can be fluid responsive via SVV and PLR that don't need fluid. MAP and CVP used together (key word there, together) to tease that out. Moreover, using CVP with those other indices is how we decide when and if to start an inopressor in these types of patients." Care to say that again? I'm not even sure what you are saying. Got a paper to prove it? "As far as ETCO2 with PLR goes, do the authors control for pulmonary pathology? Fibrotic lung disease, acute lung injury, COPD, lung contusion, whatever? There are so many confounding factors that affect ETCO2 that the CCM journal your authors cite only say that it MAY predict it in SOME circumstances. Hardly reliable information. There are so many more accurate predictors, that's just looking for a solution to a problem that doesn't exist." What proof are you providing? I've provided data and papers. You?

"Those words really don't have any meaning for me." Thats youre downfall friend. Its a simple lack of understanding on your part. Good luck.

/thread

etco2 has no place? Podcast 162 - Assessing Fluid Responsiveness [h=3]ETCO2[/h] A PLR-induced increase in EtCO2 >5 % predicted a fluid induced increase in CI >15 % with sensitivity of 71 % (95 % confidence interval: 48–89 %) and specificity of 100 (82–100) %. (Intensive Care Med (2013) 39:93–100) Passive leg raise to etco2 (CCM 2014;42:1585) (Intensive Care Med (2013) 39:93–100)

Obituary: pulmonary artery catheter 197

Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. - PubMed - NCBI

And Manny Rivers was (and still is revered for his work). However medicine moves on. Thus the Sepsis protocols!

You clearly don't understand dynamic vs static indices. By defintion a CVP is static. No? By definition an ultrasound is not? No? Look up PLR and ETCO2. Look up Paul Marik and John Myburgh.

Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. - PubMed - NCBI End all be all cvp

Based on what data? Both (CVP/Swans) have generally been proven ineffective as indices of volume responsiveness and fluid status in and of itself. They are static measurements. Unless of course you are following a trend. You are better then but still lagging behind in the game volume interpretation. We need DYNAMIC indices. And more and more I am beginning to think a PLR and ETCO2 might be the best indicator. There are others. IVC ultrasound and svv and whatnot.

I'd say cardiac but why not just jump in? Straight to the ICU???

the one that hears the lungs

AKA mistakes still happen and cerebral edema is the one you most want to watch for, Or do you not agree? I mean there is is also hyper/hypo kalemia. Seizures, not even sure why i'm typing this just check the up to date!