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.

Healthy Fat Loss For A Longer Life

Healthy Fat Loss For A Longer Life

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