The use of Guyton's approach to the control of cardiac output for clinical fluid management.

Central venous pressure Means systemic filling pressure Right atrial pressure Right ventricle Stressed volume Vascular volume Venous return

Journal

Annals of intensive care

ISSN: 2110-5820

Titre abrégé: Ann Intensive Care

Pays: Germany

ID NLM: 101562873

Informations de publication

Date de publication:
04 Jul 2024

Historique:

received: 27 03 2024

accepted: 17 05 2024

medline: 4 7 2024

pubmed: 4 7 2024

entrez: 4 7 2024

Statut: epublish

Résumé

Infusion of fluids is one of the most common medical acts when resuscitating critically ill patients. However, fluids most often are given without consideration of how fluid infusion can actually improve tissue perfusion. Arthur Guyton's analysis of the circulation was based on how cardiac output is determined by the interaction of the factors determining the return of blood to the heart, i.e. venous return, and the factors that determine the output from the heart, i.e. pump function. His theoretical approach can be used to understand what fluids can and cannot do. In his graphical analysis, right atrial pressure (RAP) is at the center of this interaction and thus indicates the status of these two functions. Accordingly, trends in RAP and cardiac output (or a surrogate of cardiac output) can provide important guides for the cause of a hemodynamic deterioration, the potential role of fluids, the limits of their use, and when the fluid is given, the response to therapeutic interventions. Use of the trends in these values provide a physiologically grounded approach to clinical fluid management.

Identifiants

DOI: 10.1186/s13613-024-01316-z PMID: 38963533

pubmed: 38963533

doi: 10.1186/s13613-024-01316-z

pii: 10.1186/s13613-024-01316-z

doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

105

Informations de copyright

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