Antonio Messina1,2, Lorenzo Calabrò3, Luca Pugliese3, Aulona Lulja3, Alexandra Sopuch3, Daniela Rosalba4, Emanuela Morenghi3,5, Glenn Hernandez6, Xavier Monnet7,8,9, Maurizio Cecconi3,5. 1. Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, Milano, Italy. antonio.messina@humanitas.it. 2. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy. antonio.messina@humanitas.it. 3. Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center-IRCCS, Via Alessandro Manzoni, 56, 20089, Rozzano, Milano, Italy. 4. Università del Piemonte Orientale, Vercelli, Italy. 5. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy. 6. Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile. 7. Hôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Medical Intensive Care Unit, Le Kremlin-Bicêtre, F-94270, Paris, France. 8. Université Paris-Saclay, AP-HP, Service de médecine intensive-réanimation, Hôpital de Bicêtre, Paris, France. 9. DMU CORREVE, Inserm UMR S_999, FHU SEPSIS, Groupe de Recherche Clinique CARMAS, Le Kremlin-Bicêtre, Paris, France.
Abstract
INTRODUCTION: Fluid challenges are widely adopted in critically ill patients to reverse haemodynamic instability. We reviewed the literature to appraise fluid challenge characteristics in intensive care unit (ICU) patients receiving haemodynamic monitoring and considered two decades: 2000-2010 and 2011-2021. METHODS: We assessed research studies and collected data regarding study setting, patient population, fluid challenge characteristics, and monitoring. MEDLINE, Embase, and Cochrane search engines were used. A fluid challenge was defined as an infusion of a definite quantity of fluid (expressed as a volume in mL or ml/kg) in a fixed time (expressed in minutes), whose outcome was defined as a change in predefined haemodynamic variables above a predetermined threshold. RESULTS: We included 124 studies, 32 (25.8%) published in 2000-2010 and 92 (74.2%) in 2011-2021, overall enrolling 6,086 patients, who presented sepsis/septic shock in 50.6% of cases. The fluid challenge usually consisted of 500 mL (76.6%) of crystalloids (56.6%) infused with a rate of 25 mL/min. Fluid responsiveness was usually defined by a cardiac output/index (CO/CI) increase ≥ 15% (70.9%). The infusion time was quicker (15 min vs 30 min), and crystalloids were more frequent in the 2011-2021 compared to the 2000-2010 period. CONCLUSIONS: In the literature, fluid challenges are usually performed by infusing 500 mL of crystalloids bolus in less than 20 min. A positive fluid challenge response, reported in 52% of ICU patients, is generally defined by a CO/CI increase ≥ 15%. Compared to the 2000-2010 decade, in 2011-2021 the infusion time of the fluid challenge was shorter, and crystalloids were more frequently used.
INTRODUCTION: Fluid challenges are widely adopted in critically ill patients to reverse haemodynamic instability. We reviewed the literature to appraise fluid challenge characteristics in intensive care unit (ICU) patients receiving haemodynamic monitoring and considered two decades: 2000-2010 and 2011-2021. METHODS: We assessed research studies and collected data regarding study setting, patient population, fluid challenge characteristics, and monitoring. MEDLINE, Embase, and Cochrane search engines were used. A fluid challenge was defined as an infusion of a definite quantity of fluid (expressed as a volume in mL or ml/kg) in a fixed time (expressed in minutes), whose outcome was defined as a change in predefined haemodynamic variables above a predetermined threshold. RESULTS: We included 124 studies, 32 (25.8%) published in 2000-2010 and 92 (74.2%) in 2011-2021, overall enrolling 6,086 patients, who presented sepsis/septic shock in 50.6% of cases. The fluid challenge usually consisted of 500 mL (76.6%) of crystalloids (56.6%) infused with a rate of 25 mL/min. Fluid responsiveness was usually defined by a cardiac output/index (CO/CI) increase ≥ 15% (70.9%). The infusion time was quicker (15 min vs 30 min), and crystalloids were more frequent in the 2011-2021 compared to the 2000-2010 period. CONCLUSIONS: In the literature, fluid challenges are usually performed by infusing 500 mL of crystalloids bolus in less than 20 min. A positive fluid challenge response, reported in 52% of ICU patients, is generally defined by a CO/CI increase ≥ 15%. Compared to the 2000-2010 decade, in 2011-2021 the infusion time of the fluid challenge was shorter, and crystalloids were more frequently used.
Authors: M Cecconi; G Monti; M A Hamilton; M Puntis; D Dawson; M L Tuccillo; G Della Rocca; R M Grounds; A Rhodes Journal: Minerva Anestesiol Date: 2012-05 Impact factor: 3.051
Authors: Maurizio Cecconi; M Ignacio Monge García; Manuel Gracia Romero; Johannes Mellinghoff; Francesca Caliandro; Robert Michael Grounds; Andrew Rhodes Journal: Anesth Analg Date: 2015-01 Impact factor: 5.108
Authors: Xavier Monnet; Mario Rienzo; David Osman; Nadia Anguel; Christian Richard; Michael R Pinsky; Jean-Louis Teboul Journal: Intensive Care Med Date: 2005-07-30 Impact factor: 17.440
Authors: Antonio Messina; Salvatore M Romano; Aycan Ozdemirkan; Paolo Persona; Riccardo Tarquini; Gianmaria Cammarota; Stefano Romagnoli; Francesco Della Corte; Victoria Bennett; Manuel I Monge García; Maurizio Cecconi; Didier Payen Journal: Eur J Anaesthesiol Date: 2021-01 Impact factor: 4.330
Authors: Antonio Messina; Davide Colombo; Federico Lorenzo Barra; Gianmaria Cammarota; Giacomo De Mattei; Federico Longhini; Stefano Romagnoli; Francesco DellaCorte; Daniel De Backer; Maurizio Cecconi; Paolo Navalesi Journal: Crit Care Date: 2019-01-28 Impact factor: 9.097
Authors: Antonio Messina; Antonio Dell'Anna; Marta Baggiani; Flavia Torrini; Gian Marco Maresca; Victoria Bennett; Laura Saderi; Giovanni Sotgiu; Massimo Antonelli; Maurizio Cecconi Journal: Crit Care Date: 2019-07-29 Impact factor: 9.097