Hospitals & Services
Peripheral perfusion, capillary refill time
Heart rate, blood pressure, JVP and urine output
Urea and creatinine
Bicarbonate and base excess
Fluid balance – at best a rough guide
Charted losses of all types
Predictors of increased cardiac output in response to administration of fluid
CVP and Pulmonary artery pressures (particularly diastolic), and pulmonary artery occlusion pressure: useful in patients with "normal" lungs and right heart function. In other patients a trend in pressures may be useful.
Cardiac output and cardiac index
PiCCO derived estimates of intra-thoracic blood volume and extra vascular lung water
Variation in arterial wave form peak with positive pressure ventilatory cycle.
This is a notoriously difficult aspect of critical care practice. Often the decision to administer fluid is governed by a conglomeration of each of the above factors. If you are in any doubt consult the duty intensive care specialist, but do not delay the administration of fluid in the acute resuscitation phase.
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