The solutions aimed to prepare GPs to receive individual cancer patients with better responsiveness, and to avoid the problems identified by both patients and healthcare professionals.
We recently proposed using a 100 mL fluid challenge to test fluid responsiveness in order to avoid fluid overload, but this was validated only in mechanically ventilated patients [ 16].
In our previous publications we also used hypotension/filling pressure criteria for defining clinical hypovolemia as a common trigger for fluid challenges [ 24, 28, 32]; we evaluated the predictive values for fluid responsiveness of other measurements later, to avoid confounding by giving fluids on the basis of allegedly superior predictors of fluid responsiveness than CVP.
Introduction Predicting fluid responsiveness is of paramount importance to avoid unnecessary fluid administration in ARDS patients, since a positive fluid balance is associated with ARDS mortality (1).
PPV has been advocated to indicate volume responsiveness - in part in order to avoid unnecessary fluid loading.
To avoid compromising the responsiveness of the instrument, the four-point scale was expanded to a six-point scale following focus group discussions and cognitive testing.
Assessing cardiac preload and fluid responsiveness accurately is important when attempting to avoid unnecessary volume replacement in the critically ill patient, which is associated with increased morbidity and mortality.
Assessment of fluid responsiveness prior to volume expansion is critical to avoid fluid overload, which has been associated with poor outcomes.
Conversely, an accurate assessment of fluid responsiveness prior to volume expansion is critical to avoid fluid overload, which has been associated with increased morbidity and mortality in critically ill patients [4 6].
For responsiveness and agility disruptive events must be managed locally to avoid propagating the effects along the value chain.
