Predicting fluid responsiveness: A review of literature and a guide for the clinician

Jalil, Bilal; Cavallazzi, Rodrigo

doi:10.1016/j.ajem.2018.08.037

Cited by 33 publications

(34 citation statements)

References 79 publications

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“…Dynamic methods in fluid responsiveness identification are more accurate (Theerawit et al, 2016 ; Guérin et al, 2013 ) , but some of them require invasive procedures like arterial line insertion, and also, not all of them can provide continuous readings. Minimally or non-invasive cardiac output monitors have the least prerequisites and can be used in a variety of critically ill patients for estimating CO rapidly (Jalil & Cavallazzi, 2018 ) to minimize the risk (Scheer et al, 2002 ) to already ill patients.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of fluid responsiveness in mechanically ventilated patients in surgical intensive care unit by pleth variability index and inferior vena cava diameter

Aboelnile

Elseidy

Kenawey

et al. 2020

Ain-Shams J Anesthesiol

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Background Patients may have signs of hypovolemia, but fluid administration is not always beneficial. We are in need of bedside devices and techniques, which can predict fluid responsiveness effectively and safely. This study is aiming to compare the effectiveness and reliability of the pleth variability index (PVI) and IVC distensibility index (dIVC) as predictors of fluid responsiveness by simultaneous recordings in all sedated mechanically ventilated patients in the surgical intensive care unit (ICU). We used the passive leg raising test (PLR) as a harmless reversible technique for fluid challenge, and patients were considered responders if the cardiac index (CI) measured by transthoracic echocardiography (TTE) increased ≥ 15% after passive leg raising test (PLR). Results This observational cross-sectional study was performed randomly on 88 intubated ventilated sedated patients. Compared with CI measured by transthoracic echocardiography, the dIVC provided 79.17% sensitivity and 80% specificity at a threshold value of > 19.42% for fluid responsiveness prediction and was statistically significant (P < .0001), with an area under the curve (AUC) of 0.886 (0.801–0.944), while PVI at a threshold value of > 14% provided 93.75% sensitivity and 87.5% specificity and was statistically significant (P < .0001), with an AUC of 0.969 (0.889–0.988). Conclusion PVI and dIVC are effective non-invasive bedside methods for the assessment of fluid responsiveness in ICU for intubated ventilated sedated patients with sinus rhythm, but PVI has the advantage of being continuous, operator-independent, and more reliable than dIVC.

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Section: Discussionmentioning

confidence: 99%

“…Methods for assessment of volume responsiveness depending on what and how surrogate is measuring can be classified into static and dynamic measures (Jalil & Cavallazzi, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Prediction of fluid responsiveness in mechanically ventilated patients in surgical intensive care unit by pleth variability index and inferior vena cava diameter

Aboelnile

Elseidy

Kenawey

et al. 2020

Ain-Shams J Anesthesiol

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“…Optimizing CO by increasing preload is based on the assumption that increased blood volume may subsequently promote stroke volume (SV) as described by the Frank-Starling law. Predicting uid responsiveness is to test whether the patient was in the ascending part of the Frank-Starling curve (preload dependence state) and may bene t from uid treatment [24,[27][28][29][30]. Although numerous measurements can predict FR, the uid challenge is a gold standard for assessing FR and is widely used.…”

Section: Discussionmentioning

confidence: 99%

“…Central venous-to-arterial carbon dioxide partial pressure (Pcv-aCO 2 ) and central venous oxygen saturation (ScvO 2 ) are two parameters expected to be effective in clinical practice. In this study, we attempt to observe changes in physiological parameters and evaluate their predictive abilities in mini uid challenge [24][25][26].…”

mentioning

confidence: 99%

A Mini-fluid Challenge of 200 mL Predicts fluid Responsiveness Using Pulmonary Artery Catheter in Septic Shock Patients an Observational Study

Yang

Weng

Jiang

et al. 2020

Preprint

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Background: Mini-fluid challenge may predict fluid responsiveness and limit fluid overload. This study was designed to explore the minimal infusion volume in effectively predicting fluid responsiveness in septic shock patients.Methods: ICU septic shock patients with indwelling pulmonary artery catheter received five sequential intravenous boluses of 100 mL 4% gelatin. Cardiac output was measured with thermodilution before fluid challenge (baseline) and three minutes after each bolus. Fluid responsiveness (FR) was defined as an increase in CO greater than 10% after 500 mL fluid infusion. The smallest volume which can perform an effective fluid challenge was analyzed. Results: Forty-seven patients were included in this prospective study. After 500 mL volume expansion, thirty-six patients presented with FR (77%) and 11 patients were fluid nonresponders. A mini fluid of 100 mL colloid had a poor predictive value (AUC = 0.67, p > 0.05). The minimal volume required to predict FR in a mini fluid challenge was 200 mL. An increase in CO greater than 5.2% after 200 mL colloid infusion was able to predict FR with a sensitivity of 83.3% and specificity of 90.9%. The AUC under the ROC curve was 0.93 (95% CI: 0.84 – 1, p < 0.05). Conclusion: In septic shock patients, a minimal volume of 200 mL 4% gelatin could reliably detect fluid responders and nonresponders.Trial registration: ClinicalTrial.gov (NCT01941472). Registered on 13 September 2013.

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“…Third, a further increase in CO, cardiac function index (CFI) and dPmax was attributed to a positive inotropic effect of phenylephrine. However, there was no correlation with echocardiographic measurements, the gold standard for assessment of LV contractility [ 21 – 23 ].…”

Section: All That Glitters Is Not Goldmentioning

confidence: 99%

Phenylephrine-induced recruitable preload from the venous side

Jacobs¹,

Lochy²,

Malbrain

2018

J Clin Monit Comput

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Predicting fluid responsiveness: A review of literature and a guide for the clinician

Cited by 33 publications

References 79 publications

Prediction of fluid responsiveness in mechanically ventilated patients in surgical intensive care unit by pleth variability index and inferior vena cava diameter

Prediction of fluid responsiveness in mechanically ventilated patients in surgical intensive care unit by pleth variability index and inferior vena cava diameter

A Mini-fluid Challenge of 200 mL Predicts fluid Responsiveness Using Pulmonary Artery Catheter in Septic Shock Patients an Observational Study

Phenylephrine-induced recruitable preload from the venous side

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