Fluid resuscitation is a vital element in critical care. Since the advent of the concept of early goal-directed therapy, we have placed a huge emphasis on aggressive fluid resuscitation in patients with shock. Yet, there is huge variability in the current practice regarding fluid challenges (FC) that can lead to under- or overhydration of the compromised patient and have an impact on morbidity and mortality. This session reviews the concepts of fluid responsiveness by utilizing the six evidence-based principles to guide effective resuscitation (ie, the six pillars) as the foundation of resuscitation. Included is a discussion of the use of chest x-ray, central venous pressure and ultrasound as poor indicators of fluid status. While passive leg raising (PLR) and the use of noninvasive cardiac output monitoring can offer more accurate information, it is important for the nurse to understand that the hemodynamic response to FC is short lived, and the response to an FC does not equate to the need for additional fluid. This session provides insight to the science of effective resuscitation.
Learning Objectives:
- Describe the complications associated with ineffective fluid resuscitation.
- Discuss the six evidence-based principles that can be utilized to guide effective resuscitation.
- Describe the relationship between fluid resuscitation and responsiveness/tolerance.
Members who are logged will be provided with a CE Credit link (below) for the duration of 3 years from the original presentation date (noted above). After 3 years, CE will no longer be made available. Members however are still welcome to watch the presentation independently for non-CE credit.
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Speaker(s):Daria C. Ruffolo, DNP, RN, ACNP-BC, CCRN spent nearly 20 years as a bedside nurse in the surgical/trauma intensive care venue before taking on the role as an Acute Care Nurse Practitioner, with the Anesthesia/Critical care team at a busy urban medical center. Daria is certified in both critical care and trauma. She is also credentialed as a certified specialist in adult care. In her role as an ACNP she does critical care evaluation, pre-operative assessment and risk stratification for the operative patient population. Prior to this role she served as the ACNP to the trauma/surgical critical care team for 12 years. She is an assistant professor in the graduate program of Loyola University School of Nursing, has spoken at over 200 national conferences, and published on the topics of trauma/critical care. Daria has served as a nurse missionary in areas such as the outback of Australia, Papua New Guinea, Slovakia, Dominican Republic, South Africa and Ecuador.
