Last week our residents and faculty met for journal club in search of the holy grail.. err.. I mean, to talk about ways to assess volume responsiveness. A couple of weeks back the PGY-1 and 2 residents met and discussed a number of questions they had about the care and management of patients with sepsis. The discussion hit on a number of key topics: empiric antibiotic selection, timing of antibiotics, choice of vasopressors, etc. Ultimately the group decided they wanted to take a closer look at non-invasive ways to assess volume responsiveness and guide resuscitation in septic patients. After searching the literature, they decided to take a closer look at these articles:

Kanji, H., McCallum, J., Sirounis, D., MacRedmond, R., Moss, R., & Boyd, J. (2014). Limited echocardiography-guided therapy in subacute shock is associated with change in management and improved outcomes. Journal of Critical Care, 29(5), 700 – 705. doi:10.1016/j.jcrc.2014.04.008 Duus N, et al, The reliability and validity of passive leg raise and fluid bolus to assess fluid responsiveness in spontaneously breathing emergency department patients, J Crit Care (2014), http://dx.doi.org/10.1016/j.jcrc.2014.07.031 Kupersztych-Hagege, E., Teboul, J., Artigas, A., Sabatier, C., Richard, C., & Monnet, X. (2013) Bioreactance is not reliable for estimating cardiac output and the effects of passive leg raising in critically ill patients. British Journal of Anaesthesia. 11(6). doi:10.1093/bja/aet282