Muhammad Saad, Muhammad Ameen, Muhammad Adrish


Fluid resuscitation is considered a cornerstone therapy in the management of critically ill patients. Estimation of volume requirements using an appropriate diagnostic strategy is a cumbersome process and an area of uncertainty. In many studies, clinicians’ use of physical examination has been challenged, and several strategies for hemodynamic assessment utilizing imaging and physiologic models have been proposed. Broadly classified into static and dynamic indices, these interventions are based on point measurements as well as variations in the indices. There is no consensus among various societies about ideal testing, which is usually dependent on the clinician's discretion, availability of infrastructure and institutional preference. In this review, we attempt to elaborate the commonly used fluid assessment methods in the medical-surgical and cardiac critical care units.





Full Text:



Hughes RE, Magovern GJ. The relationship between right atrial pressure and blood volume [abstract]. Arch Surg 1959; 79:238

Wilson JN, Grow JB. Central venous pressure in optimal blood volume maintenance. Arch Surg 1962; 85:55

Lloyd D. Maclean, M.D, John H. Duff, M.D. The Use of Central Venous Pressure as a Guide to Volume Replacement in Shock CHEST journal August 1965Volume 48, Issue 2, Pages 199–205.

Henry S. Loeb, M.D., Edward B. J. Winslow, M.D. Acute Hemodynamic Effects of Dopamine in Patients with Shock. Circulation, Volume XLIV, August 1971.

Weil MH, Henning RJ: New concepts in the diagnosis and fluid treatment of circulatory shock. Anesth Analg 1979; 58:124 –132

Forrester JS, Diamond G, McHugh TJ, et al. Filling pressures in the right and left sides of the heart in acute myocardial infarction: a reappraisal of central-venous-pressure monitoring. N Engl J Med 1971; 285:190 –192

J A Cairns Hemodynamic monitoring in acute myocardial infarction. Can Med Assoc J. 1979 Oct 6; 121(7): 905–910. PMCID: PMC1704481

Baek SM, Makabaki GG, Bryan-Brown CW, et al. Plasma expansion in surgical patients with high central venous pressure (CVP): the relationship of blood volume to hematocrit, CVP, pulmonary wedge pressure, and cardiorespiratory changes. Surgery 1975; 78:304 –315

Magder SA, Georgiadis G, Tuck C (1992) Respiratory variations in right atrial pressure predict response to fluid challenge, J Crit Care 7:7645

Boldt J, Lenz M, Kumle B, Papsdorf M. Volume replacement strategies on intensive care units: results from a postal survey. . Intensive Care Med. 1998;24:147–151. doi: 10.1007/s001340050536.

Deborah J. Cook, MD, FRCPC, MSc (Epid); David L. Simel, MD, MHS Does This Patient Have Abnormal Central Venous Pressure? JAMA. 1996; 275(8):630-634. doi:10.1001/jama.1996.03530320054034

S. Magder. More respect for the CVP. Intensive Care Meal (1998) 24:651-653 © Springer-Verlag 1998.

Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345:1368 –1377

Paul E. Marik, MD, FCCP; Michael Baram, MD, FCCP; and Bobbak Vahid, MD. Does Central Venous Pressure Predict Fluid Responsiveness? A Systematic Review of the Literature and the Tale of Seven Mares. CHEST / 134/1/ JULY, 2008 DOI: 10.1378/chest.07-2331

Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006; 354:2564 –2575

Magder SA, Georgoadis G, Cheong T. Respiratory variations in right atrial pressure predicts response to fluid challenge. J Crit Care 1992; 20:29 – 42

Marik PE, Baram M. Non-invasive hemodynamic monitoring in the intensive care unit. Crit Care Clin 2007; 23:383– 400

Osman D, Ridel C, Ray P, et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge. Crit Care Med 2007; 35: 64-8

Michael R Pinsky, John A Kellum and Rinaldo Bellomo Central venous pressure is a stopping rule, not a target of fluid resuscitation Critical Care and Resuscitation Volume 16 Number 4 December 2014

ARISE and ANZICS writers. "Goal-directed resuscitation for patients with early septic shock". The New England Journal of Medicine. 2014. 371(16):1496-1506.

Process Investigators, Yealy, D.M., Kellum, J.A. et al, A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014;370:1683–1693.

Mouncey PR, et al. "Trial of early, goal-directed resuscitation for septic shock". The New England Journal of Medicine. 2015. 372(14):1301-1311.

Cecconi M, Hofer C, Teboul JL, Pettila V, Wilkman E, Molnar Z, et al. Fluid challenges in intensive care: the FENICE study: a global inception cohort study. Intensive Care Med. 2015;41:1529–1537. doi: 10.1007/s00134-015-3850.

Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, et al. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med. 2006;34:344–353. doi: 10.1097/01.CCM.0000194725.48928.3A.

Cannesson M, Pestel G, Ricks C, Hoeft A, Perel A. Hemodynamic monitoring and management in patients undergoing high risk surgery: a survey among North American and European anesthesiologists. Crit Care. 2011;15:R197. doi: 10.1186/cc10364.

Lauralyn A McIntyre, Paul C Hébert.A survey of Canadian intensivists' resuscitation practices in early septic shock. Crit Care. 2007; 11(4): R74. Published online 2007 Jul 10. doi: 10.1186/cc5962. PMID: 17623059

Daniel De Backer and Jean-Louis Vincent Should we measure the central venous pressure to guide fluid management? Ten answers to 10 questions. Critical Care201822:43

Akmal AH, Hasan M, Mariam A. The incidence of complications of central venous catheters at an intensive care unit. Ann Thorac Med. 2007;2(2):61–63.

Magder S. How to use central venous pressure measurements. Curr Opin Crit Care. 2005;11(3):264-270.

David A. Farcy, MD; Ashika Jain, MD; Michael Dalley, DO; Thomas M. Scalea, MD. Pitfalls in Using Central Venous Pressure as a Marker of Fluid Responsiveness.

Namkje AR Vellinga, Can Ince Elevated central venous pressure is associated with impairment of microcirculatory blood flow in sepsis: a hypothesis generating post hoc analysis.BMC Anesthesiology2013 © Vellinga et al.; licensee BioMed Central Ltd. 2013.

Stewart RD, Psyhojos T, Lahey SJ, et al (1998) Central venous catheter use in low-risk coronary artery bypass grafting. Ann Thorac Surg 66:1306-1311.

Judson B. Williams, Eric D. Peterson Central Venous Pressure After Coronary Artery Bypass Surgery: Does it Predict Postoperative Mortality or Renal Failure? J Crit Care. 2014 Dec; 29(6): 1006–1010. Published online 2014 Jun 9. doi: 10.1016/j.jcrc.2014.05.027.

R. Venn, A. Steele Randomized controlled trial to investigate influence of the fluid challenge on duration of hospital stay and perioperative morbidity in patients with hip fractures. BJA: British Journal of Anaesthesia, Volume 88, Issue 1, 1 January 2002, Pages 65–71 Published 01 January 2002.

Buhre W, Weyland A, Schorn B, et al (1999) Changes in central venous pressure and pulmonary capillary wedge pressure do not indicate changes in right and left heart volume in patients undergoing coronary artery bypass surgery. Eur J Anaesthesiol 16:11-17

Thomsen HS, Lokkegaard H, Munck O (1987) Influence of normal central venous pressure on onset of function in renal allografts. Scand J Urol Nephrol 21:143-145.

Smyrniotis V., Kostopanagiotou G., Theodoraki K., Tsantoulas D., Contis J.C. The role of central venous pressure and type pf vascular control in blood loss during major hepatic resections. Am J Surg. 2004;187:398–402.

Dunki-Jacobs E.M., Philips P., Scoggins C.R., McMaster K.M., Martin R.C.G. Stroke volume variation in hepatic resection: a replacement for standard central venous pressure monitoring. Ann Surg Oncol. 2014;21:473–478.

Francesca Ratti, Federica Cipriani, Raffaella Reineke, Intraoperative monitoring of stroke volume variation versus central venous pressure in laparoscopic liver surgery: a randomized prospective comparative trial. 2016 Feb; 18(2): 136–144. Published online 2015 Dec 16. doi: 10.1016/j.hpb.2015.09.005.

Claus U. Niemann, John Feiner Central Venous Pressure Monitoring During Living Right Donor Hepatectomy. Liver Transpl 13:266-271,2007 AASLD. Received March 7, 2006; accepted October 19, 2006.

Karen B. Domino, T. Andrew Bowdle. Injuries and Liability Related to Central Vascular Catheters: A Closed Claims Analysis. Anesthesiology 6 2004, Vol.100, 1411-1418.

Jeger RV, Lowe AM, Buller CE, Pfisterer ME, Dzavik V, Webb JG, et al. Hemodynamic parameters are prognostically important in cardiogenic shock but similar following early revascularization or initial medical stabilization: a report from the SHOCK Trial. Chest. 2007;132(6):1794–803.

J.V.Collins, T.R.Evans. CENTRAL VENOUS PRESSURE IN ACUTE MYOCARDIAL INFARCTION THE LANCET. Volume 297, Issue 7695, 20 February 1971, Pages 373-37.

G. Qian, Z. Fu, J. Guo, F. Cao, Y. ChenPrevention of contrast-induced nephropathy by central venous pressure–guided fluid administration in chronic kidney disease and congestive heart failure patients J Am Coll Cardiol Intv, 9 (2016), pp. 89-96.

Saraschandra Vallabhajosyula, Jacob C. Role of CVP to Guide Fluid Therapy in Chronic Heart Failure Lessons From Cardiac Intensive CareVolume 9, Issue 6, March 2016DOI: 10.1016/j.jcin.2015.12.278

Daniel De Backer, Jean-Louis Vincent Should we measure the central venous pressure to guide fluid management? Ten answers to 10 questions Crit Care. 2018; 22: 43.Published online 2018 Feb 23. doi: 10.1186/s13054-018-1959-3.

James S. Forrester, M.D., George Diamond Filling Pressures in the Right and Left Sides of the Heart in Acute Myocardial Infarction — A Reappraisal of Central-Venous-Pressure Monitoring. N Engl J Med 1971; 285:190-193 DOI: 10.1056/NEJM197107222850402.

Biais M, Ehrmann S, Mari A, Conte B, Mahjoub Y, Desebbe O, et al. Clinical relevance of pulse pressure variations for predicting fluid responsiveness in mechanically ventilated intensive care unit patients: the grey zone approach. Crit Care. 2014;18:587

Murphy GS, Nitsun M. Is the pulmonary artery catheter useful? Best Pract Res Clin Anaesthesiol. 2005 Mar;19(1):97-110.

Greenberg SB, Murphy GS, Vender JS. Current use of the pulmonary artery catheter. Curr Opin Crit Care. 2009;15:249–253.Ann Intensive Care. 2013; 3: 38.

Paul E Marik Obituary: pulmonary artery catheter 1970 to 2013. Published online 2013 Nov 28. doi: 10.1186/2110-5820-3-38 PMID: 24286266.

Bobby D. Nossaman, M.D. Brittni A. Scruggs, B.S History of Right Heart Catheterization: 100 Years of Experimentation and Methodology Development. Cardiol Rev. 2010 Mar–Apr; 18(2): 94–101.

Umesh K. Gidwani, MD, Bibhu Mohanty. The Pulmonary Artery Catheter. A Critical Reappraisal. DOI:

Forssmann W. Die Sondierung des rechten Herzens. Klin Wochenschr. 1929; 8: 2085.

Ganz W, Donosco R, Marcus HS, Forrester JS, Swan HJ. A new technique for measurement of cardiac output by thermodilution in man. Am J Cardiol. 1971;27:392–396. doi: 10.1016/0002-9149(71)90436.

Cournand A. Cardiac catheterization: development of the technique, its contributions to experimental medicine, and its initial application in man. Acta Med Scand Suppl. 1975; 579: 1–32.

Swan HJ, Ganz W, Forrester J, Marcus H, Diamond G, Chonette D. Catheterization of the heart in man with the use of a flow-directed balloon-tipped catheter. N Engl J Med. 1970; 283: 447.

Dexter L, Haynes FW, Burwell CS, Eppinger EC, Seibel RE, Evans JM. Studies of congenital heart disease, I: technique of venous catheterization as a diagnostic procedure. J Clin Invest. 1947;26:547–553. doi: 10.1172/JCI101839.

Robin ED. The cult of the Swan-Ganz catheter. Overuse and abuse of pulmonary flow catheters. Ann Intern Med. 1985 Sep;103(3):445-9.

Connors AF Jr, Speroff T, The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA. 1996 Sep 18;276(11):889-97.

Sandham JD. Pulmonary artery catheter use--refining the question. Crit Care Med. 2004;32:1070–1071.

Harvey S, Harrison DA, Singer M, et al. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet. 2005;366:472–47.

Richard C, Warszawski J, Anguel N, Deye N, Combes A, Barnoud D, Boulain T, Lefort Y, Fartoukh M, Baud F. French Pulmonary Artery Catheter Study Group et al. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome. JAMA. 2003;290:2713–2720. doi: 10.1001/jama.290.20.2713.

Wheeler AP, Bernard GR, Thompson BT, et al. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med. 2006;354:2213–2224.

Binanay C, Califf RM, Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA. 2005 Oct 5; 294(13):1625-33.

Rhodes A, Cusack RJ, Newman PJ, et al. A randomised, controlled trial of the pulmonary artery catheter in critically ill patients. Intensive Care Med. 2002;28:256–264.

Chittock DR, Dhingra VK, Ronco JJ, et al. Severity of illness and risk of death associated with pulmonary artery catheter use. Crit Care Med. 2004;32:911–915.

Rubenfeld GD, McNamara-Aslin E, Rubinson L. The pulmonary artery catheter, 1967-2007: rest in peace? JAMA. 2007;298:458–461

Michard F, Descorps-Declere A. The times are a-changin’: should we bury the yellow catheter? Crit Care Med. 2007;35:1427–1428.

Chittock DR. The pulmonary artery catheter and critical care: the cart is before the horse. Crit Care Med. 2006;34:1820–1822.

Dalen JE, Bone RC. Is it time to pull the pulmonary artery catheter? JAMA. 1996; 276: 916.

Rajaram SS, Desai NK, Cochrane group. Pulmonary artery catheters for adult patients in intensive care. Published: 28 February 2013

Forrester JS, Diamond G, Chatterjee K, Swan HJC. Medical therapy of acute myocardial infarction by application of hemodynamic subsets (part I). N Engl J Med. 1976; 295: 1356–1362.

Katrin Fink. Accuracy and precision of transcardiopulmonary thermodilution in patients with cardiogenic shock. Clin Monit Comput

Crexells C, Chatterjee K, Forrester JS, Dikshit K, Swan HJC. Optimal level of left heart filling pressures in acute myocardial infarction. N Engl J Med. 1973; 289: 1263–1266.

Weber KT, Janicki JS, Russell RO, Rackley CE. Identification of high risk subsets of acute myocardial infarction: derived from the Myocardial Infarction Research Units Co-operative Data Bank. Am J Cardiol. 1978; 41: 197.

Cohen MG, Kelly RV, Kong DF, Menon V, Shah M, Ferreira J, Pieper KS, Criger D, Poggio R, Ohman EM, Gore J, Califf RM, Granger CB. Pulmonary artery catheterization in acute coronary syndromes: insights from the GUSTO IIb and GUSTO III trials. Am J Med. 2005; 118: 482.

Robin ED. Death by pulmonary artery flow-directed catheter: time for a moratorium? Chest. 1987; 92.

Dalen JE. The pulmonary artery catheter: friend, foe or accomplice? JAMA. 2001; 286.

Mathay MA, Chatterjee K. Bedside catheterization of the pulmonary artery: risks compared with benefits. Ann Intern Med. 1988; 109: 826–834.

Zion MM, Balkin J, Rosenmann D, et al. Use of Pulmonary Artery Catheters in Patients With Acute Myocardial Infarction. Analysis of Experience in 5,841 Patients in the SPRINT Registry. Chest. 1990;98(6):1331–1335.

Shoemaker WC, Appel PL, Kram HB, Waxman K, Lee TS. Prospective trial of supranormal values of survivors as therapeutic goals in high risk surgical patients. Chest. 1988; 94: 1176–1186.

Eisenberg PR, Jaffe AS, Schuster DP. Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients. Crit Care Med. 1984;12:549–553. doi: 10.1097/00003246-198407000-00001.

Boyd O, Grounds RM, Bennett ED. A randomized clinical trial of the effect of deliberate perioperative increase of oxygen delivery on mortality in high-risk surgical patients. JAMA 1993;270:2699-2707

Del Guercio LRM, Cohn JD. Monitoring operative risk in the elderly. JAMA 1980;243:1350-1355

James Dean Sandham, M.D. A Randomized, Controlled Trial of the Use of Pulmonary-Artery Catheters in High-Risk Surgical Patients. N Engl J Med 2003; 348:5-14 DOI: 10.1056/NEJMoa021108.

Fellahi JL, Parienti JJ, Hanouz JL, et al. Perioperative use of dobutamine in cardiac surgery and adverse outcome: propensity adjusted analysis. Anesthesiology 2008; 108:979–987.

Pinsky MR, Vincent JL.Let us use the pulmonary artery catheter correctly and only when we need it. Crit Care Med. 2005 May; 33(5):1119-22.

Marco Ranucci Which cardiac surgical patients can benefit from placement of a pulmonary artery catheter? Crit Care. 2006; 10(Suppl 3): S6. Published online 2006 Nov 27. doi: 10.1186/cc4833. PMID: 17164018.

Ashley Miller, MBChB FRCA FFICM and Justin Mandeville, Predicting and measuring fluid responsiveness with echocardiography. Echo Res Pract. 2016 Jun; 3(2): G1–G12. PMCID: PMC4989101

Haijun Huang, Qinkang Shen, Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation: a systematic review and meta-analysis. Critical Care201822:204.

Barbier C, Loubieres Y, Schmit C, Hayon J, Ricome JL, Jardin F, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Med. 2004;30: 1740-6

Long E, Oakley E, Duke T, Babl FE. Does respiratory variation in inferior vena cava diameter predict fluid responsiveness: a systematic review and meta-analysis. Shock 2017;47: 550-559.

C. Mitaka, T. Nagura, Two-dimensional echocardiographic evaluation of inferior vena cava, right ventricle, and left ventricle during positive-pressure ventilation with varying levels of positive end-expiratory pressure.Crit Care Med, 17 (1989), pp. 205-210

Cheriex EC, Leunissen KM, Janssen JH, Mooy JM, van Hooff JP. Echography of the inferior vena cava is a simple and reliable tool for estimation of ‘dry weight’ in haemodialysis patients. Nephrol Dial Transplant. 1989;4: 563–8.

Zhang Z, Xu X, Ye S, Xu L. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound Med Biol. 2014;40:845–53.

Theerawit P , Morasert T Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis. J Crit Care. 2016 Dec;36:246-251. doi: 10.1016/j.jcrc.2016.07.023. Epub 2016 Aug 13.

Vignon P, Repesse X, Begot E, Leger J, Jacob C, Bouferrache K, et al. Comparison of echocardiographic indices used to predict fluid responsiveness in ventilated patients. Am J Respir Crit Care Med. 2017;195:1022–32

Broilo F, Meregalli A, Friedman G. Right internal jugular vein distensibility appears to be a surrogate marker for inferior vena cava vein distensibility for evaluating fluid responsiveness. Rev Bras Ter Intensiva. 2015;27:205–211. doi: 10.5935/0103-507X.20150042.

Miller JB, Sen A, Strote SR Inferior vena cava assessment in the bedside diagnosis of acute heart failure. Am J Emerg Med. 2012 Jun;30(5):778-83. doi: 10.1016/j.ajem.2011.04.008. Epub 2011 Jun 12

Sascha N. Goonewardena, Anthony Gemignani, Comparison of Hand-Carried Ultrasound Assessment of the Inferior Vena Cava and N-Terminal Pro-Brain Natriuretic Peptide for Predicting Readmission After Hospitalization for Acute Decompensated Heart Failure. Am J Cardiol. 1990 Aug 15;66(4):493-6.

Brennan JM, Blair JE, Goonewardena SA comparison by medicine residents of physical examination versus hand-carried ultrasound for estimation of right atrial pressure. J Cardiol. 2007 Jun 1;99(11):1614-6. Epub 2007 Apr 18.

Zhang J, Critchley LA. Inferior Vena Cava Ultrasonography before General Anesthesia Can Predict Hypotension after Induction. Anesthesiology. 2016 Mar;124(3):580-9.

Guo-guang Ma, Guang-wei Hao, Internal jugular vein variability predicts fluid responsiveness in cardiac surgical patients with mechanical ventilation. Ann Intensive Care. 2018; 8: 6. PMID: 29340792

Sefidbakht S, Assadsangabi R, Abbasi HR, Nabavizadeh A. Sonographic measurement of the inferior vena cava as a predictor of shock in trauma patients. Emerg Radiol. 2007;14:181–5.

Ayhan Kaydu and Erhan Gokcek Preoperative and Postoperative Assessment of Ultrasonographic Measurement of Inferior Vena Cava: A Prospective, Observational Study. J Clin Med. 2018 Jun; 7(6): 145. PMID: 29890776.

Thudium M, Klaschik S, Ellerkmann RK, Putensen C, Hilbert T. Is internal jugular vein extensibility associated with indices of fluid responsiveness in ventilated patients? Acta Anaesthesiol Scand. 2016;60:723–733. doi: 10.1111/aas.12701

Monnet X, Rienzo M. Passive leg raising predicts fluid responsiveness in the critically ill. Crit Care Med. 2006 May;34(5):1402-7.

Jabot J, Teboul JL. Passive leg raising for predicting fluid responsiveness: importance of the postural change. Intensive Care Med. 2009 Jan;35(1):85-90. doi: 10.1007/s00134-008-1293-3. Epub 2008 Sep 16.

Lakhal K, Ehrmann S. Central venous pressure measurements improve the accuracy of leg raising-induced change in pulse pressure to predict fluid responsiveness. Intensive Care Med. 2010 Jun;36(6):940-8. doi: 10.1007/s00134-010-1755-2. Epub 2010 Jan 29.

Fabio Cavallaro, Claudio Sandroni. Diagnostic accuracy of passive leg raising for prediction of fluid responsiveness in adults: systematic review and meta-analysis of clinical studies. September 2010, Volume 36, Issue 9, pp 1475–1483.

Marik PE, Cavallazzi R. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature. Crit Care Med. 2009 Sep;37(9):2642-7. doi: 10.1097/CCM.0b013e3181a590da.

T. G. V. Cherpanath, B. F. Geerts. Basic concepts of fluid responsiveness. Neth Heart J. 2013 Dec; 21(12): 530–536. Published online 2013 Oct 30. doi: 10.1007/s12471-013-0487-7 PMCID: PMC3833913

Xavier Monnet, Paul E. Marik, Prediction of fluid responsiveness: an update. Ann Intensive Care. 2016; 6: 111. Published online 2016 Nov 17. doi: 10.1186/s13613-016-0216-7 PMCID: PMC5114218.

Corl K, Napoli AM, Gardiner F. Bedside sonographic measurement of the inferior vena cava caval index is a poor predictor of fluid responsiveness in emergency department patients. Emerg Med Australas. 2012; 24:534–539. doi: 10.1111/j.1742-6723.2012.01596. x.

Boulain T, Achard JM, Teboul JL, Richard C, Perrotin D, Ginies G. Changes in BP induced by passive leg raising predict response to fluid loading in critically ill patients. Chest. 2002; 121:1245–1252. doi: 10.1378/chest.121.4.1245.

Zorko N Kamenik M, Starc V..The effect of Trendelenburg position, lactated Ringer's solution and 6% hydroxyethyl starch solution on cardiac output after spinal anesthesia. Anesth Analg. 2009 Feb;108(2):655-9. doi: 10.1213/ane.0b013e31818ec9e5.

Reuter DA, Felbinger TW. Trendelenburg positioning after cardiac surgery: effects on intrathoracic blood volume index and cardiac performance. Eur J Anaesthesiol. 2003 Jan;20(1):17-20.

Frost H, Mortensen CR. Postoperative volume balance: does stroke volume increase in Trendelenburg's position? Clin Physiol Funct Imaging. 2017 May;37(3):314-316. doi: 10.1111/cpf.12306. Epub 2015 Oct 30.

Christoph Karl Hofer, Martin Geisen, Reliability of Passive Leg Raising, Stroke Volume Variation and Pulse Pressure Variation to Predict Fluid Responsiveness During Weaning From Mechanical Ventilation After Cardiac Surgery: A Prospective, Observational Study. Turk J Anaesthesiol Reanim. 2018 Apr; 46(2): 108–115. Published online 2018 Apr 1. doi: 10.5152/TJAR.2018.29577

Fakhari S, Bilehjani E, The effect of passive leg-raising maneuver on hemodynamic stability during anesthesia induction for adult cardiac surgery. Integr Blood Press Control. 2018 Jun 7;11:57-63. doi: 10.2147/IBPC.S126514. eCollection 2018.

Bentzer P, Griesdale DE, Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids? JAMA. 2016 Sep 27;316(12):1298-309. doi: 10.1001/jama.2016.12310.


  • There are currently no refbacks.