The often observed superiority of cardiac volumes over filling pressures in predicting and monitoring cardiac output responses, that is, fluid responsiveness, may indeed be overestimated by the phenomenon, as recently described by our group also [ 1, 6- 8, 10- 18, 19, 19, 27].
Among these contributors, a marked decrease in cardiac output and adrenergic responsiveness of cardiovascular system is the main reason [ 1, 4, 7].
In physiology, CCR could be defined as the spontaneous magnitude from basal to maximal cardiac power output and/or its responsiveness under stress test [ 4].
Can the results obtained by Rivers and cowokers [ 1] be replicated even when less invasive forms of monitoring (e.g. esophageal Doppler-based estimates of cardiac output and preload responsiveness) are substituted for measurements of ScvO2?
A substantial amount of physiological studies [ 8, 9] have demonstrated that static preload indices (such as central venous pressure (CVP)) may not be reliable to assess fluid responsiveness (cardiac output change in response to fluid administration), especially in septic patients.
If no attempts are made to predict the response of cardiac output to volume expansion, "fluid responsiveness" occurs in only half the patients [13].
Given its responsiveness to output, a lively rebound in trade is not inconceivable.
The Picanto also shares the new "Kappa" engine range recently launched in the revised i10, modern units low on CO2 output and high on responsiveness.
Then, fluid resuscitation should be pursued and titrated according to indicators of preload responsiveness, cardiac output, and tissue oxygenation markers.
