Making Waves With Fluid Responsiveness 

Critically ill patients often have complicated hemodynamics, and functional hemodynamic monitoring is a useful indicator for how a patient will respond to fluid administration.

Attendees learned about fluid responsiveness, applications and limitations of hemodynamic tests, and hemodynamic treatment algorithms at “Hemodynamic Monitoring’s New Waves: Sound Waves, Pressure Waves, Maneuvers and More” on Monday.  

“Monitoring helps us answer the question of whether to administer fluids or whether consideration of alternative interventions is the better clinical choice,” said Joya D. Pickett, critical care clinical nurse specialist at Swedish Health Services System in Seattle. “These tests help us predict whether a patient would do better or not with fluids, defined as an increase in stroke volume.”  

Preventing deleterious effects associated with fluid overload is the main reason we should use these tests, Pickett said. 

However, the application of fluid responsiveness tests is lacking in the clinical arena. Nurses, who have a pivotal role in implementing change in healthcare, can influence their facility’s use of hemodynamic monitoring. “Sharing evidence-based practice with all members of the healthcare team on a day-to-day basis is a key role for nurses,” Pickett said. “Nurses are the frontline leaders that have the ability to truly represent the patient’s voice.”