SMACC Debate – Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time

April 12, 2016 by Scott Weingart 7 Comments

Summary by: Roger Harris

Rob MacSweeney and Paul Marik debate whether the assessment of fluid responsiveness in the resuscitation of patients with shock a waste of time? Both Marik and MacSweeney agree that many of the traditional methods of assessing patients volume status are flawed and of no value. Marik goes on to argue that the only clinically meaningful outcome that we should measure in response to a fluid challenge is Stoke Volume. In at least 50% of patients there is no improvement in stroke volume and further treatment with fluid boluses will only likely cause harm. Marik goes on to argue that we must know where our patients are position on their Frank-Starling curve to predict whether they are fluid responsive and we can assess this with passive led raise.

See the Intensive Care Network Site for the Original Audio and Paul's Slides

Author
Recent Posts

Scott Weingart

An ED Intensivist from NY. No conflicts of interest (coi).

Latest posts by Scott Weingart (see all)

EMCrit 260 – Thoughts on the NEJM Acute Upper Airway Obstruction Review - November 30, 2019
EMCrit 259 – Cardiogenic Shock — The Next Level & Mechanical Circulatory Support with Jenelle Badulak - November 13, 2019
Letter to the Editor – High-Sensitivity Troponin is not a Myth, and “Myth-busting” is often another Myth to be Busted - November 10, 2019

Cite this post as:

Scott Weingart. SMACC Debate – Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time. EMCrit Blog. Published on April 12, 2016. Accessed on December 11th 2019. Available at [https://emcrit.org/emcrit/smacc-debate-rob-mac-sweeney-vs-paul-marik-predicting-fluid-responsiveness-waste-time/ ].

Financial Disclosures

Unless otherwise noted at the top of the post, the speaker(s) and related parties have no relevant financial disclosures.

You finished the 'cast,
Now get CME credit

Already an EMCrit CME Subscriber?
Click Here to Get CME Credit for the Episode

Not a subcriber yet? Why the heck not?
By subscribing, you can...

Get CME hours
Support the show
Write it off on your taxes or get reimbursed by your department

Subscribe Now

If you enjoyed this post, you will almost certainly enjoy our others. Subscribe to our email list to keep informed on all of the Resuscitation and Critical Care goodness.

This Post was by the EMCrit Crew, published 4 years ago. We never spam; we hate spammers! Spammers probably work for the Joint Commission.

7

Comment Here

newest oldest most voted

Global Intensive Care | SMACC Debate – Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time

[…] post SMACC Debate – Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time appeared first on FOAM EM […]

FLUID RESPONSE – SMACC DEBATE |

[…] to Scott Weingart for editing this video – and letting us share it! See his post at EMCRIT, and the full post on this debate at Intensive Care Network for the original audio and […]

Guest

Abbasi

The most important point here is: we know PLR predicts fluid responsiveness but does that mean we keep giving fluids until the pt is no longer fluid responsive? What evidence is there for that because as they mention in the talk we are all fluid responsive but that doesn’t mean we all need to be infused.

Monnet – The Bottom Line

[…] [SMACC podcast via EmCrit] Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time […]

Predicting Fluid Responsiveness by Passive Leg Raise (PLR) - R.E.B.E.L. EM - Emergency Medicine Blog

[…] Scott Weingart at EMCrit: Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time […]

POCUS: Moretti – The Bottom Line

[…] [further listening] SMACC Debate – Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time […]

Predicting Fluid Responsiveness by Passive Leg Raise (PLR) - REBEL EM - Emergency Medicine Blog

[…] Scott Weingart at EMCrit: Rob MacSweeney vs Paul Marik – Predicting Fluid Responsiveness is a Waste of Time […]