The best method to access the adequacy of replacement of fluid a case of shock:
Correct Answer: Increase in urine output
Description: C i.e. Increase in urine outputUrine output is quantitative and relatively reliable indicator of organ perfusionQThe most reliable clinical guide in assessing hypovolumic shock is skin perfusion. (skin on the extremeties becomes pale, cool and moist)As a general principle, measurements of blood pressure and pulse are less reliable than change in urine output in assessing the severity of shock.B.P : Hypotension is not a reliable early sign of hypovolumea. In healthy patient blood volume must decrease by 30-40% before hypotension occur.CVP: CVP measurement helps in distinguishing b/w Cardiogenesis shock and hypovolumic shock."A Central venous catheter can give information about the relationship b/w intravascular volume & right ventricular function but should not be used to assess either factor independently."CVP is not a good indicator in septic shock because patient can develop pulmonary edema when it is in the normal range.
Category:
Physiology
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