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  • Utilizing a novel point of ...
    Akinjero, Akintunde; Chulani, Sunil; Ahmad, Sahar

    Respiratory medicine case reports, 01/2022, Letnik: 38
    Journal Article

    Volume assessment is an important, but challenging but crucial aspect of patient care. Fluid balance is affected by volume expansion, sepsis/shock states, cardiac and kidney failure and is present in the majority of patients. Similarly, in critically ill patients on diuretics, both excessive and inadequate diuresis can worsen outcomes. Chest X-ray (CXR) and auscultation are poorly predictive of volume status, while bioimpedance and blood volume monitoring have limitations at the bedside 4. Inferior vena cava (IVC) diameter as measured by POCUS is a marker of intravascular volume that can provide a real-time assessment to guide diuresis. The Reverse Falls Protocol combines lung and IVC US to enable the clinician to visualize, in real-time, the patient's intravascular and extravascular volume and to set diuresis goals. We present a series of cases where euvolemia was achieved using the principles described by O'Hara, Chabra & Ahmad's Reverse Falls Protocol.