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UPSC-CMS 2017 — General Medicine

Q: Which of the following is NOT considered as an indicator of adequate fluid resuscitation?

Respiratory rate. ***Respiratory rate*** - While an *elevated respiratory rate* can indicate *hypovolemia* or other systemic stress, it is a **less specific** and less direct indicator of the adequacy of *fluid resuscitation* compared to *perfusion parameters*. - Changes in *respiratory rate* can be influenced by many factors such as *pain*, *anxiety*, *metabolic acidosis*, and primary *pulmonary issues*, making it less reliable for guiding *fluid therapy*. *Pulse* - A *decreasing pulse rate* and *improving pulse quality* (becoming stronger and less thready) are good indicators of **improved cardiac output** and *volume status* during *fluid resuscitation*. - A *persistently high* or *weak pulse* suggests ongoing *hypovolemia* or inadequate *fluid replacement*. *Urine output* - *Adequate urine output* (typically >0.5 mL/kg/hr in adults) is a critical indicator of **sufficient renal perfusion** and overall *systemic hydration*. - A *rising urine output* after *fluid administration* signifies that organs are receiving adequate blood flow and *fluid balance* is improving. *Blood pressure* - An *increasing blood pressure*, particularly improvement in *mean arterial pressure*, directly reflects **better systemic perfusion** and resolution of *hypotension* caused by *hypovolemia*. - Normalization of *blood pressure* indicates that the *circulatory volume* is adequate to maintain vital organ function. [Practice more General Medicine PYQs on OnCourse]

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Which of the following is NOT considered as an indicator of adequate fluid resuscitation?