Prédiction de la réponse à l'expansion volémique chez les patients en ventilation spontanée

Predicting which patients will respond to volume expansion in case of spontaneous breathing activity is a difficult issue. Neither the static markers of cardiac preload nor the respiratory variation of the arterial pulse pressure is reliable for predicting fluid responsiveness in case of spontaneous breathing. The changes in cardiac output in response to a passive leg raising test allows a simple and reliable prediction of fluid responsiveness. More recently, the hemodynamic response to a 15 seconds end-expiratory occlusion test has been demonstrated to predict the hemodynamic response to fluid administration.