Revisión sistemática y metaanálisis de la prueba de fluidos en el diagnóstico de la capacidad de respuesta a administración de fluidos.
What is the impact of the fluid challenge technique on diagnosis of fluid responsiveness? A systematic review and meta-analysis
Keywords:
prueba de fluidos, capacidad de respuesta del fluido, terapia de fluidos, reanimación con fluidos.Abstract
El objetivo de este estudio fue describir la “prueba de fluidos” y evaluar la diferencia en la proporción de "respondedores" (PR) según el tipo de fluido, el volumen, la duración de la infusión y el momento de la evaluación.
Métodos: Se realizaron búsquedas en MEDLINE y Embase para estudios que utilizan la prueba de fluidos como una prueba de precarga cardíaca con una descripción de la técnica, una definición reportada de capacidad de respuesta de fluidos y PR. El resultado primario fue la PR media, según el volumen de líquido, el tipo de líquidos, la tasa de infusión y el tiempo de evaluación.
Resultados: se incluyeron un total de 85 estudios (3601 pacientes) en el análisis. Las PR fueron 54.4% (IC 95% 46.9-62.7) donde se administró <500 ml, 57.2% (IC 95% 52.9-61.0) donde se administraron 500 ml y 60.5% (IC 95% 35.9-79.2) donde> 500 ml fue administrado (p = 0.71). El PR no se vio afectado por el tipo de fluido. La RP fue similar entre los pacientes a los que se administró una prueba de fluidos durante <15 minutos (59.2%, IC 95% 54.2-64.1) y durante 15-30 minutos (57.7%, IC 95% 52.4-62.4, p = 1). Cuando el tiempo de infusión fue ≥30 minutos, hubo una PR menor de 49.9% (IC 95% 45.6-54, p = 0.04). La respuesta se evaluó al final de la exposición a los fluidos, entre 1 y 10 minutos, y > 10 minutos después de la exposición a los fluidos. Las proporciones de respondedores fueron 53.9%, 57.7% y 52.3%, respectivamente (p = 0.47).
Conclusiones: el PR disminuye con un tiempo de infusión largo. Es deseable estandarizar la prueba de fluidos.
Palabras clave: prueba de fluidos, capacidad de respuesta del fluido, terapia de fluidos, reanimación con fluidos.
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2024-09-19
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Macias Pingarrón, J. P. (2024). Revisión sistemática y metaanálisis de la prueba de fluidos en el diagnóstico de la capacidad de respuesta a administración de fluidos.: What is the impact of the fluid challenge technique on diagnosis of fluid responsiveness? A systematic review and meta-analysis. Revista Electrónica AnestesiaR, 10(6). Retrieved from https://revistaanestesiar.org/index.php/rear/article/view/350
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