• Live CME Symposia 08
• On-line CME Symposia

EXPANDED APPLICATIONS FOR HEMODYNAMIC MONITORING 2009:

APCO and dynamic variables of volume status: Clinical Application

Program Description / Statement of Need:

Volume status remains an important question in critical care medicine.  Traditional methods of assessing volume status based on clinical data are unreliable.  Static pressure measurements utilizing either the central venous pressure or the pulmonary artery occlusion pressure have poor sensitivity and specificity as measures of volume responsiveness.  Dynamic parameters of fluid responsiveness, such as stroke volume variation, can be obtained from analysis of the arterial waveform.  These data have consistently been shown to be more reliable in predicting volume responsiveness. Differences in systolic pressure and pulse pressure are generated by changes in stroke volume during the respiratory cycle.  Positive pressure ventilation provides a consistent physiologic challenge to the patient which in turn tests the need for volume. An individual Starling curve can be plotted to determine the optimal stroke volume for a given stroke volume variation. In addition, a physiologic algorithm has been developed using stroke volume variation as a predictor of volume responsiveness and stroke volume as a cardiac performance measure together to optimize hemodynamics under a variety of conditions. 

Target Audience:
This program has been designed for a multidisciplinary physician and nurse audience including: ICU / Anesthesia / Peri-op / Intensivists / Trauma / Critical Care

Program Objectives:

By the end of the session the participant will be able to:

1. - Describe the effects of positive pressure ventilation on stroke volume variation.
2. - Plot on a Starling curve a patient’s individual response to fluid.
3. - Apply a simplified algorithm using stroke volume index and stroke volume variation as a means to improve cardiac performance.

Accreditation:
This CME activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of The Institute for Medical Studies (IMS) and ScientiaCME. IMS is accredited by the ACCME to provide CME for physicians. IMS designates this educational activity for a maximum of 1.0 hours AMA PRA Category 1 Credits™ . Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurses may claim credit for activities approved for AMA PRA Category 1 Credits™ in most states, for up to 50% of the nursing requirement for recertification. This course is designated for 0.75 AMA PRA Category 1 Credits™

Release Date: September 1, 2009
Expiration Date: August 30, 2010

Faculty: William T. McGee, MD

Faculty Disclosures

Viewing Requirements:

On-line symposium:

Instructions:

• Read the learning objectives above
• Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
• View the on-line program. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
• Take the post-test
• Complete the program evaluation and CME registration. A CE certificate will be emailed to you within 30 days.

Perform Pre-Test (optional)

Download the Presentation (optional)

View the on-line program

Perform Post-Test