Vnitr Lek 2024, 70(4):255-259

Assessment of the fluid status and fluid therapy optimization in the emergency department: Is inferior vena cava a reliable marker?

Jiří Müller, Martin Matějovič

I. interní klinika Lékařské fakulty UK a FN Plzeň

Infusion therapy, in terms of fluid resuscitation, is without a doubt one of the most common therapeutic intervention in the management of an acutely ill patient. Despite the growing body of evidence showing potentially harmful effects of non-indicated fluid administration, this "fluid-reflex" remains a common practice in the Emergency department. One of the reasons for this is that fluid status assessment, based just on the clinical findings, is generally difficult if the patient does not have extreme fluid balance disturbances. Inferior Vena Cava ultrasound provides a relatively quick and simple answer to the basic clinical question: "Does my patient need fluids or decongestion?" However, this seemingly straightforward information is redeemed by several limitations which must be considered assessing the hemodynamics of medical emergencies.

Keywords: fluid status, point-of-care ultrasound, inferior vena cava, fluid therapy, fluid tolerance, fluid responsiveness, fluid balance, emergency department, volume status.

Accepted: June 5, 2024; Published: June 20, 2024  Show citation