The decision whether to give more fluid during the management of shock can be somewhat provider-dependent. This multicenter prospective cohort study evaluated 1639 patients with hypotension requiring vasopressors.

The authors determined if the use of a physiological assessment consisting of central venous pressure or pulmonary artery occlusion pressure, stroke volume variation, pulse pressure variation, passive leg raise test, or critical care ultrasound would impact the amount of IV fluid or vasopressor use. While not performed often, physiological assessment is associated with increased vasopressor use and no significant difference in IV fluid utilization or in-hospital mortality.

The jury remains out on best practices for determining fluid responsiveness.

The use of physiological assessment does not appear to be associated with changes of in-hospital mortality. More research is ongoing.

Read More