CME: Fluid First: Using PLR and SVV to Optimize Volume
ACCREDITATION EXPIRED: February 28, 2015
Activity Description / Statement of Need:
In this online CME self-learning program:
Fluid administration is a first line intervention for patients with unstable cardiovascular status. However, two major problems exist with this intervention: only one half of the patients who receive fluid respond favorably and standard static parameters do not reliably assess the response to fluid. In patients with hemodynamic instability, dynamic parameters such as pulse pressure variation and stroke volume variation are shown to be better predictors of preload responsiveness than static parameters such as central venous pressures and pulmonary artery wedge pressures. Evidence incorporating dynamic parameters in decision–making algorithms favors improved patient outcomes. In addition, a simple maneuver such as passive leg raising is being promoted as a means of providing the patient with a “reversible physiologic” fluid challenge.
Agenda:
- - Fluid: the merits … and risks … of volume expansion
- - Monitoring indices: static vs. dynamic
- - Hemodynamic interplay: stroke volume and stroke volume variation
- - Prediction of fluid responsiveness
- - Risks of fluid therapy and altered stroke volume variation unrelated to fluid
- - The role of patient positioning
- - Summary of the evidence
Target Audience:
This program has been designed for a multidisciplinary physician and nurse audience including: Emergency Medicine / ICU / Anesthesia / Peri-op / Intensivists / Trauma / Critical Care
Supported through an educational grant from Edwards Lifesciences
Release Date: September 02, 2011 -- Expiration Date: February 28, 2015
Faculty: Jan Headley, RN
Agenda
Learning Objectives
By the end of the session the participant will be able to:
- Define the static and dynamic parameters used in assessing fluid status.
- Describe the hemodynamic effects of the passive leg raising technique.
- Cite research related to assessment of fluid responsiveness.
Accreditation
ACCREDITATION FOR THIS COURSE HAS EXPIRED. YOU MAY VIEW THE PROGRAM, BUT CME / CE IS NO LONGER AVAILABLE AND NO CERTIFICATE WILL BE ISSUED.
Faculty Disclosure and Resolution of COI
As an accredited provider of continuing medical education, it is the policy of the ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is not to prevent a person with a significant financial or other relationship from participating in CME activities, but rather to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity: for this CME activity, any COI has been resolved through content review by ScientiaCME.
Faculty Disclosure: Jan Headley, RN, BS, discloses that she is employed by Edwards Lifesciences as Director of Professional Education.
Disclosures of Educational Planners: Steven Sachse is an officer and part owner of ScientiaCME, LLC, which has received a grant from the commerical supporter of this program: Edwards Lifesciences.
Disclosures of Educational Reviewer: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC, which has received a grant from the commerical supporter of this program: Edwards Lifesciences.
Commercial Support Disclosure: Supported through an educational grant from Edwards Lifesciences, a manufacturer of medical devices.
Instructions
- Read the learning objectives above
- Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
- View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
- Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
- Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.
System Requirements
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh
*Required to view Printable PDF Version
Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.