The clinical determination of the intravascular volume can be extremely difficult in critically ill
and injured patients as well as those undergoing major surgery. This is problematic because
fluid loading is considered the first step in the resuscitation of hemodynamically unstable
patients. Yet, multiple studies have demonstrated that only approximately 50% of
hemodynamically unstable patients in the intensive care unit and operating room respond to
a fluid challenge. Whereas under-resuscitation results in inadequate organ perfusion …

The clinical determination of the intravascular volume can be extremely difficult in critically ill
and injured patients as well as those undergoing major surgery. This is problematic as fluid
loading is considered the first step in the resuscitation of hemodynamically unstable
patients. Yet, multiple studies have demonstrated that only about 50% of hemodynamically
unstable patients in the ICU and operating room respond to a fluid challenge. Cardiac filling
pressures including the central venous pressure and pulmonary artery occlusion pressure …