• Cyril Charron, Vincent Caille, François Jardin, and Antoine Vieillard-Baron.
• Medical Intensive Care Unit, University Hospital Ambroise Paré, Assistance Publique Hôpitaux de Paris, Boulogne, France.
• Curr Opin Crit Care. 2006 Jun 1;12(3):249-54.

Purpose Of ReviewFluid responsiveness is a relatively new concept. It enables the efficacy of volume expansion to be predicted before use, rather than assessed afterwards, thus avoiding inappropriate fluid infusion. Echocardiography is a fantastic noninvasive tool which can directly visualize the heart and assess cardiac function. Its use was long limited by the absence of accurate indices to diagnose hypovolemia and predict the effect of volume expansion. In the last few years, several French teams have used echocardiography to develop new parameters of fluid responsiveness, taking advantage of its ability to monitor cardiac function beat by beat during the respiratory cycle.Recent FindingsIn mechanically ventilated patients perfectly adapted to the respirator, respiratory variations in superior and inferior vena cava diameters and in left ventricular stroke volume have been validated as parameters of fluid responsiveness. In our opinion, the collapsibility index of the superior vena cava is the most reliable of these parameters, but does require transesophageal echocardiography.SummaryEchocardiography has been widely demonstrated to predict fluid responsiveness accurately. This is now a complete and noninvasive tool able to accurately determine hemodynamic status in circulatory failure.

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