Fluid Responsiveness and Heart Lung Interactions

Echocardiography is an essential tool to guide fluid management in cardiopulmonary resuscitation of critically ill patients. Critical care echocardiography combines static measures, such as size and variability of the vena cava and dynamic measurements such as heart lung interactions and stroke volume variation to assess “volume status” and predict response to volume resuscitation. A thorough understanding of these echocardiographic measures, the physiology behind them, and their strengths and limitations in clinical practice are essential to accurately guide fluid management. In this chapter we review the clinical application of echocardiography to guide resuscitation in spontaneously breathing and mechanically ventilated patients.