Skip to main content

Stroke volume variation guided fluid therapy in septic shock with ARDS


Optimal fluid resuscitation guided by central venous pressure (CVP) in patients having septic shock with ARDS is a perplexed issue having risk of underfilling and worsening of shock versus fluid overload leading to pulmonary edema. Whether stroke volume variation (SVV) (Flotrac-Vigileo system) guided fluid resuscitation has an impact on improvement of shock, oxygenation and mortality were tested in this single-center prospective study [1, 2].


Inclusion criteria were: (1) septic shock patients with dose of norepinephrine ≥0.1 μg/kg/minute or dopamine ≥10 μg/kg/minute; (2) CVP ≥12 mmHg; (3) PO2/FiO2 ratio ≤200 with ARDSnet protocol ventilation under deep sedation. Exclusion criteria were atrial/ventricular arrhythmias, spontaneous triggering of inspiration, established renal failure needing continuous renal replacement therapy (CRRT). During the 24-hour study period, SVV was continuously monitored with the third-generation Flotrac-Vigileo system (version 3.02). Intravenous fluids were given in the boluses of 250 to 500 cm3 to keep SVV <12% throughout the study period. Vasopressor infusion was titrated to keep MAP >70 mmHg.


Thirty-seven patients with severe sepsis-induced multiorgan dysfunction syndrome with average APACHE II score of 24.6 and PEEP of 8.2 cm were enrolled. SVV guided fluids received during the 24-hour study period were 5.1 ± 2.6 l. Arterial lactates reduced significantly without worsening of hypoxia. The PO2/FiO2 ratio increased significantly at 24 hours. Twenty-two out of 37 survived (59.45%) until hospital discharge. See Table 1.

Table 1 Hemodynamic variables at 0 and 24 hours


SVV guided fluid therapy in septic shock with ARDS may improve shock by optimizing preload in a targeted way without worsening oxygenation.


  1. Intensive Care Med. 2011, 37: 233-240. 10.1007/s00134-010-2098-8

  2. Crit Care Med. 2008, 36: 2810-2816. 10.1097/CCM.0b013e318186b74e

Download references

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Jog, S., Patel, D., Patel, M. et al. Stroke volume variation guided fluid therapy in septic shock with ARDS. Crit Care 16 (Suppl 1), P233 (2012).

Download citation

  • Published:

  • DOI:


  • Septic Shock
  • Central Venous Pressure
  • Continuous Renal Replacement Therapy
  • Fluid Resuscitation
  • Septic Shock Patient