• Ann Fr Anesth Reanim · Jul 2014

    Review

    Intraoperative management of heart-lung interactions: "From hypothetical prediction to improved titration"

    • A Ouattara, A Dewitte, and H Rozé.
    • Université de Bordeaux, adaptation cardiovasculaire à l'ischémie, U1034, 33600 Pessac, France; Inserm, adaptation cardiovasculaire à l'ischémie, U1034, 33600 Pessac, France; Service d'anesthésie-réanimation II, maison du Haut-Lévêque, groupe hospitalier Sud, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France. Electronic address: alexandre.ouattara@chu-bordeaux.fr.
    • Ann Fr Anesth Reanim. 2014 Jul 1;33(7-8):476-9.

    AbstractExtensive literature describes the suitability of dynamic parameters to predict responsiveness in fluid. However, based on heart-lung interactions, these parameters can have serious limitations, including the use of protective lung ventilation. Although the latter seems to be beneficial for healthy patients undergoing high-risk surgery, the intraoperative interpretation of dynamic parameters to predict fluid responsiveness can be hazardous. In this context, the attending physician could, alternatively, titrate the need of fluids with a small fluid challenge, which remains unaffected by low tidal volume, the presence of arrhythmia, or the presence of spontaneous ventilation. When intraoperative prediction of fluid responsiveness is required in mechanically ventilated patients, "improved" titration should be preferred to a hypothetical prediction.Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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