Assessment of volume status and fluid responsiveness in the emergency department: a systematic approach

Med Klin Intensivmed Notfmed. 2017 May;112(4):326-333. doi: 10.1007/s00063-015-0124-x. Epub 2015 Dec 16.


When treating acutely ill patients in the emergency department (ED), the successful management of a variety of medical conditions, such as sepsis, acute kidney injury, and pancreatitis, is highly dependent on the correct assessment and optimization of a patient's intravascular volume status. Therefore, it is crucial that the ED physician knows and uses available means to assess intravascular volume status to adequately guide fluid therapy. This review focuses on techniques for volume status assessment that are available in the ED including basic clinical and laboratory findings, apparatus-based tests such as sonography and chest x-ray, and functional tests to evaluate fluid responsiveness. Furthermore, we provide an outlook on promising innovative, noninvasive technologies that might be used for advanced hemodynamic monitoring in the ED.

Keywords: Advanced hemodynamic monitoring; Fluid challenge; Fluid deficiency; Noninvasive cardiac output; Passive leg raising; Sepsis; Shock; Volume therapy.

Publication types

  • Review

MeSH terms

  • Acute Disease / therapy*
  • Blood Volume / physiology*
  • Blood Volume Determination / methods*
  • Emergency Service, Hospital*
  • Fluid Therapy / methods*
  • Hemodynamic Monitoring
  • Humans
  • Radiography, Thoracic
  • Ultrasonography