| Mean arterial pressure (MAP)1515 Futier E, Lefrant JY, Guinot PG, et al. INPRESS Study Group. Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery: A Randomized Clinical Trial. JAMA. 2017;318:1346–57.
|
Within 10% resting values >65 mmHg |
| Central venous pressure (CVP)3333 Shah P, Louis MA. Physiology, Central Venous Pressure 2022 Jul 15. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–., 3838 De Backer D, Bakker J, Cecconi M, et al. Alternatives to the Swan-Ganz catheter. Intensive Care Med. 2018;44:730–41.
|
> 8 mmHg |
|
O2/CO2-derived parameters
|
| Central venous oxygen saturation (ScvO2) |
> 70–75% |
| Oxygen Extraction Rate (O2ER)2323 Donati A, Loggi S, Preiser JC, et al. Goal-directed intraoperative therapy reduces morbidity and length of hospital stay in highrisk surgical patients. Chest. 2007;132:1817–24.
|
< 27% |
| Venoarterial carbon dioxide gradient (CO2-gap) |
< 5mmHg |
| Serum lactate (ICU) |
10% decline/hour |
|
Fluid responsiveness (consider giving fluids if no harm)
|
| Pulse Pressure Variation (PPV)1919 Michard F, Chemla D, Teboul JL. Applicability of pulse pressure variation: how many shades of grey? Crit Care. 2015;19:144., 2020 Fellahi JL, Futier E, Vaisse C, et al. Perioperative hemodynamic optimization: from guidelines to implementation-an experts’ opinion paper. Ann Intensive Care. 2021;11:58.
|
> 13% |
| Pulse Pressure Variation (PPV TV6-8)*2121 Myatra SN, Prabu NR, Divatia JV, et al. The Changes in Pulse Pressure Variation or Stroke Volume Variation After a “Tidal Volume Challenge” Reliably Predict Fluid Responsiveness During Low Tidal Volume Ventilation. Crit Care Med. 2017;45:415–21.
|
> 3.5% |
| ScvO2 increase after fluid bolus2222 Kuiper AN, Trof RJ, Groeneveld AB. Mixed venous O2 saturation and fluid responsiveness after cardiac or major vascular surgery. J Cardiothorac Surg. 2013;8:189.
|
> 2% |
| Δ ETCO2 (exhaled CO2) increase after fluid bolus3131 Toupin F, Clairoux A, Deschamps A, et al. Assessment of fluid responsiveness with end-tidal carbon dioxide using a simplified passive leg raising maneuver: a prospective observational study. Can J Anaesth. 2016;63:1033–41., 3232 Huang H, Wu C, Shen Q, et al. Value of variation of end-tidal carbon dioxide for predicting fluid responsiveness during the passive leg raising test in patients with mechanical ventilation: a systematic review and meta-analysis. Crit Care. 2022;26:20.
|
> 5% |
|
Attention /consider stop giving fluids
|
| Intra-Abdominal Pressure (IAP)3636 Malbrain ML, Marik PE, Witters I, et al. Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: a systematic review with suggestions for clinical practice. Anaesthesiol Intensive Ther. 2014;46:361–80. or CVP |
> 11 mmHg |
| Lung ultrasound |
B lines |
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