The Perioperative Use of Echocardiography for Fluid Management

Abstract

This chapter will discuss some common “static” echocardiographic measurements that can guide fluid management including echocardiographic quantification of ventricle dimensions, areas, and volumes. The chapter will mainly focus on “dynamic” echocardiographic measurements of fluid responsiveness that can guide the perioperative physician in the fluid management of patients in the operating room, the postanesthesia care unit (PACU), and in the critical care unit. These include echocardiographic quantification of inferior vena cava and superior vena cava diameters and collapsibility index to guide fluid therapy. In addition, Doppler ultrasound guided approaches to quantification of stroke volume changes both in mechanically ventilated patients (using respiratory-induced changes) and in spontaneously breathing patients (using the passive leg raising test) will be described.