Diagnosing hypovolemia

Clinical signs of hypovolemia (reduced skin turgor, low central venous pressure, oliguria, tachycardia, and hypotension) are late indicators. A high index of suspicion must be maintained; a normal heart rate, blood pressure, and central venous pressure (CVP) do not exclude hypovolemia ( Weil et,,§L 1965), and the CVP is particularly unreliable in pulmonary vascular disease, right ventricular disease, isolated left ventricular failure, and valvular heart disease. The absolute CVP and pulmonary artery wedge pressure (PAWP) are also difficult to interpret since peripheral venoconstriction may maintain CVP despite hypovolemia; indeed, in patients with an intact sympathetic response to hypovolemia the CVP may fall in response to fluid ( Baekefa/ 1975). The response to a fluid challenge is the safest method of assessment.

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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