Prediction of fluid responsiveness. What’s new?

Abstract

Although the administration of fluid is the first treatment considered in almost all cases of circulatory failure, this therapeutic option poses two essential problems: the increase in cardiac output induced by a bolus of fluid is inconstant, and the deleterious effects of fluid overload are now clearly demonstrated. This is why many tests and indices have been developed to detect preload dependence and predict fluid responsiveness. In this review, we take stock of the data published in the field over the past three years. Regarding the passive leg raising test, we detail the different stroke volume surrogates that have recently been described to measure its effects using minimally invasive and easily accessible methods. We review the limits of the test, especially in patients with intra-abdominal hypertension. Regarding the end-expiratory occlusion test, we also present recent investigations that have sought to measure its effects without an invasive measurement of cardiac output. Although the limits of interpretation of the respiratory variation of pulse pressure and of the diameter of the vena cava during mechanical ventilation are now well known, several recent studies have shown how changes in pulse pressure variation itself during other tests reflect simultaneous changes in cardiac output, allowing these tests to be carried out without its direct measurement. This is particularly the case during the tidal volume challenge, a relatively recent test whose reliability is increasingly well established. The mini-fluid challenge has the advantage of being easy to perform, but it requires direct measurement of cardiac output, like the classic fluid challenge. Initially described with echocardiography, recent studies have investigated other means of judging its effects. We highlight the problem of their precision, which is necessary to evidence small changes in cardiac output. Finally, we point out other tests that have appeared more recently, such as the Trendelenburg manoeuvre, a potentially interesting alternative for patients in the prone position.

Shown for reading. Its publisher allows quoting it, not republishing it.

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    Messina A, Colombo D, Barra FL, Cammarota G, De Mattei G, Longhini F, et al. Sigh maneuver to enhance assessment of fluid responsiveness during pressure support ventilation. Crit Care. 2019;23:31.

    Not in our library10.1186/s13054-018-2294-4

91. 91.

    Preisman S, Kogan S, Berkenstadt H, Perel A. Predicting fluid responsiveness in patients undergoing cardiac surgery: functional haemodynamic parameters including the Respiratory Systolic Variation Test and static preload indicators. Br J Anaesth. 2005;95:746-755.

    Not in our library10.1093/bja/aei262

92. 92.

    Luo JC, Su Y, Dong LL, Hou JY, Li X, Zhang Y, et al. Trendelenburg maneuver predicts fluid responsiveness in patients on veno-arterial extracorporeal membrane oxygenation. Ann Intensive Care. 2021;11:16.

    Not in our library10.1186/s13613-021-00811-x

93. 93.

    Ma GG, Xu LY, Luo JC, Hou JY, Hao GW, Su Y, et al. Change in left ventricular velocity time integral during Trendelenburg maneuver predicts fluid responsiveness in cardiac surgical patients in the operating room. Quant Imaging Med Surg. 2021;11:3133-3145.

    Not in our library10.21037/qims-20-700

94. 94.

    Monnet X, Teboul JL. My patient has received fluid. How to assess its efficacy and side effects? Ann Intensive Care. 2018;8:54.

    Not in our library10.1186/s13613-018-0400-z

95. 95.

    Adda I, Lai C, Teboul JL, Guerin L, Gavelli F, Monnet X. Norepinephrine potentiates the efficacy of volume expansion on mean systemic pressure in septic shock. Crit Care. 2021;25:302.

    Not in our library10.1186/s13054-021-03711-5

96. 96.

    Persichini R, Silva S, Teboul JL, Jozwiak M, Chemla D, Richard C, et al. Effects of norepinephrine on mean systemic pressure and venous return in human septic shock*. Crit Care Med. 2012;40:3146-3153.

    Not in our library10.1097/ccm.0b013e318260c6c3

97. 97.

    Dres M, Teboul JL, Anguel N, Guerin L, Richard C, Monnet X. Passive leg raising performed before a spontaneous breathing trial predicts weaning-induced cardiac dysfunction. Intensive Care Med. 2015;41:487-494.

    Not in our library10.1007/s00134-015-3653-0

98. 98.

    Monnet X, Julien F, Ait-Hamou N, Lequoy M, Gosset C, Jozwiak M, et al. Lactate and venoarterial carbon dioxide difference/arterial-venous oxygen difference ratio, but not central venous oxygen saturation, predict increase in oxygen consumption in fluid responders. Crit Care Med. 2013;41:1412-1420.

    Not in our library10.1097/ccm.0b013e318275cece

99. 99.

    Bednarczyk JM, Fridfinnson JA, Kumar A, Blanchard L, Rabbani R, Bell D, et al. Incorporating dynamic assessment of fluid responsiveness into goal-directed therapy: a systematic review and meta-analysis. Crit Care Med. 2017;45:1538-1545.

    Not in our library10.1097/ccm.0000000000002554

100. 100.
     The effects of goal-directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials · 2014

     No notice
101. 101.

     Dave C, Shen J, Chaudhuri D, Herritt B, Fernando SM, Reardon PM, et al. Dynamic assessment of fluid responsiveness in surgical ICU patients through stroke volume variation is associated with decreased length of stay and costs: a systematic review and meta-analysis. J Intensive Care Med. 2020;35:14-23.

     Not in our library10.1177/0885066618805410

102. 102.

     Fellahi JL, Futier E, Vaisse C, Collange O, Huet O, Loriau J, et al. Perioperative hemodynamic optimization: from guidelines to implementation-an experts' opinion paper. Ann Intensive Care. 2021;11:58.

     Not in our library10.1186/s13613-021-00845-1

103. 103.

     Messina A, Robba C, Calabro L, Zambelli D, Iannuzzi F, Molinari E, et al. Association between perioperative fluid administration and postoperative outcomes: a 20-year systematic review and a meta-analysis of randomized goal-directed trials in major visceral/noncardiac surgery. Crit Care. 2021;25:43.

     Not in our library10.1186/s13054-021-03464-1

104. 104.

     Douglas IS, Alapat PM, Corl KA, Exline MC, Forni LG, Holder AL, et al. Fluid response evaluation in sepsis hypotension and shock: a randomized clinical trial. Chest. 2020;158:1431-1445.

     Not in our library10.1016/j.chest.2020.04.025

105. 105.

     Chen C, Kollef MH. Targeted fluid minimization following initial resuscitation in septic shock: a pilot study. Chest. 2015;148:1462-1469.

     Not in our library10.1378/chest.15-1525

106. 106.

     Richard JC, Bayle F, Bourdin G, Leray V, Debord S, Delannoy B, et al. Preload dependence indices to titrate volume expansion during septic shock: a randomized controlled trial. Crit Care. 2015;19:5.

     Not in our library10.1186/s13054-014-0734-3

107. 107.

     Ehrman RR, Gallien JZ, Smith RK, Akers KG, Malik AN, Harrison NE, et al. Resuscitation guided by volume responsiveness does not reduce mortality in sepsis: a meta-analysis. Crit Care Explor. 2019;1:e0015.

     Not in our library10.1097/cce.0000000000000015

108. 108.

     Azadian M, Win S, Abdipour A, Kim CK, Nguyen HB. Mortality benefit from the passive leg raise maneuver in guiding resuscitation of septic shock patients: a systematic review and meta-analysis of randomized trials. J Intensive Care Med. 2021.

     Not in our library10.1177/08850666211019713

109. 109.

     Dubin A, Loudet C, Kanoore EV, Osatnik J, Rios F, Vasquez D, et al. Characteristics of resuscitation, and association between use of dynamic tests of fluid responsiveness and outcomes in septic patients: results of a multicenter prospective cohort study in Argentina. Ann Intensive Care. 2020;10:40.

     Not in our library10.1186/s13613-020-00659-7

110. 110.

     Vincent JL, Sakr Y. Clinical trial design for unmet clinical needs: a spotlight on sepsis. Expert Rev Clin Pharmacol. 2019;12:893-900.

     Not in our library10.1080/17512433.2019.1643235

111. 111.

     Cecconi M, Arulkumaran N, Kilic J, Ebm C, Rhodes A. Update on hemodynamic monitoring and management in septic patients. Minerva Anestesiol. 2014;80:701-711.

     Not in our library

112. 112.

     Vincent JL, Singer M, Einav S, Moreno R, Wendon J, Teboul JL, et al. Equilibrating SSC guidelines with individualized care. Crit Care. 2021;25:397.

     Not in our library10.1186/s13054-021-03813-0

Cited by papers we hold 3

• 2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department · 2023
  No notice
• Effective hemodynamic monitoring · 2022
  No notice
• A plea for personalization of the hemodynamic management of septic shock · 2022
  No notice

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