Demystifying Volume Status
Accurate assessment of a patient’s volume status > informing decisions on fluid prescribing, vasoactive agents, and decongestive therapies.
BUT, determining a patient’s volume status is challenging because of limitations in examination and investigations and the complexities of fluid homeostasis in disease states.
The notion of volume status is a familiar concept among physicians, the term remains nebulous. Classification using the terms hypervolemia, euvolemia, and hypovolemia lack the precision necessary to describe adequately the complex relationship between fluid compartments and hemodynamic factors in the cardiovascular circuit. Volume status is contextual and dynamic, rather than a uniform state with a fixed definition.
Clinicians should avoid making assumptions about a patient’s intravascular volume status based on the findings of a single compartment.
POCUS > access to these hemodynamic and structural data points as an extension and refinement of the physical examination.
Point-of-care ultrasound (POCUS) is useful in assessing hemodynamic parameters related to volume status, fluid responsiveness, and fluid tolerance. It requires understanding several physiologic concepts to interpret and integrate POCUS findings accurately into volume related clinical decision-making.
Thanks to the authors.
