cardio Roland

💧 Fluid Management in Heart Failure and Cardiogenic Shock Preload vs Congestion This chapter explains that in acute and chronic heart failure, the challenge is not simply “giving or withholding fluids” but balancing preload to support cardiac output against the risk of venous congestion and pulmonary edema. Conventional preload markers (CVP, PAOP) are often misleading in dilated, stiff or ischemic ventricles, so the authors emphasize integrated assessment using echo, blood pressure, urine output and clinical signs of congestion. Cardiogenic Shock Strategy In cardiogenic shock, small, carefully tested fluid challenges may be justified early, but ongoing hypotension is usually better addressed with inotropes, vasopressors and mechanical support rather than repetitive fluid boluses. The chapter highlights how positive fluid balance worsens outcomes in decompensated heart failure and advocates early decongestive therapy and, when needed, ultrafiltration as part of a broader deresuscitation plan. 📘 Full chapter in Rational Use of Intravenous Fluids in Critically Ill Patients: 👉 link.springer.com/book/10.10… 🔵 Discussed in depth at IFAD 2026 in Antwerp. 👉Registration: fluidacademy.org/ifad-2026-r… #HeartFailure #CardiogenicShock #FluidManagement #VEXUS #ICU