Keep EVLW in mind - PULSION Medical Systems SE

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Casus 10 � 55 jaar man met in VG AML � Nu acuut RF, 7 kg gewicht toename ondanks diarhee � CVD 32 -> lasix � Op IC: AF 34, temp 34.4, MAP 59 ST 140 � Intubatie wgs uitputting; PEEP 15; P/F ratio 115 � Zwak AG + rhochi � Licht buik distensie
PICCO � CI 5.1 SVRI 700 -> sepsis ? � CVD 24 � SVV 15% � GEDI 650 � -> ondervulling ondanks hoge CVD? � BK: enterococcen; FK: Clostridium � Aanvankelijk fluid responsive � Tevens cathecholamines � Oligurie-anurie (12 liter VB +) � Verdere fluid resuscitatie; P/F 75 CVD 29; MAP 65; SVV 13%;GEDI 780, EVLW12-> 17 � Wat nog meer ? � IAP 28 door toxic megacolon wv colectomie � CVVH IAP 16; ELWI 13; P/F 175 CVD 18-22; SVV 10-
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Keep EVLW in mind: theory and pract
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Transpulmonary thermal dilution
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Multivariate Analysis With ICU Outc
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Pulmonay vascular permeability inde
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Case histories: what about clinical
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PiCCO -CI 3.2 L/min/m 2 -GEDVI 921
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Shock and pulmonary oedema Cause of
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Conclusions � Transpulmonary ther
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The PAC/PiCCO trial. Comparison of
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Case 2 � Male, 72 years � Resus
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� Despite high-dose vasopressor t
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Other fluid overload syndromes �
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Casus 1 � Vrouw, 60 jaar (present
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� Man, 72 jaar Casus 2 � Reanim
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� De hoge EVLW-waarde in combinat
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Casus 3 � Man 57 jaar � Resecti
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Murray et al. Am Rev Respir Dis. 19
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PLI t=90 vs t=0, min-1 0.080 0.040
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Our model: Final conclusion Little
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Too much of anything anything is ba
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CV bolus injection Transpulmonary t
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ITBV TD (ml) Intrathoracic blood vo
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WP-guided EVLW-guided
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Do we need to repeat this study ?
Page 94 and 95: Global eind-diastolisch eind diasto
Page 96 and 97: Extravasculair Long Water • Extra
Page 98 and 99: Beat to Beat Cardiac Output Top en
Page 100: PiCCO en klinische vragen CO GEDV S
Page 103 and 104: PiCCO -CI 3.2 L/min/m 2 -GEDVI 921
Page 111: PiCCO -CI 2.4 L/min/m 2 -GEDVI 569
Page 114 and 115: � Man 60 jr � Koorts, rillingen
Page 116 and 117: Casus 5 � Vrouw 74 jaar, geraakt
Page 118 and 119: � Opname ICU - Maxillo-faciale fr
Page 120 and 121: Wil iemand nog meer weten ? � CI
Page 122 and 123: Dus: Lage CO tgv hypovolemie (laag
Page 124 and 125: Baseline CXR
Page 126 and 127: � Morfine/lasix � Diurese ++
Page 128 and 129: PiCCO parameters � CO = 1.8 - 2.2
Page 130 and 131: Verder beloop � Dag 2: Agitatie,
Page 132 and 133: Casus 8 � Gezonde vrouw 27 jaar m
Page 134 and 135: PiCCO parameters � CO = 7 l/min
Page 136 and 137: Casus 9 Secundair AML bij NHL Pancy
Page 138 and 139: Problemen Haemodynamiek • meer vo
Page 140 and 141: Dag 2 CI GEDVI ELWI SVRI CVP 3.5 78
Page 142 and 143: Dag 3 CI GEDVI EVLWI SVRI CVP 3.2 7
Page 146 and 147: Dus; � Vullingsdrukken vals-hoog
Page 148 and 149: Potentiele problemen zonder PiCCO b
Page 150 and 151: 5 3 7 3 Cardiac Output EVLW Preload
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Keep EVLW in mind - PULSION Medical Systems SE

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