What is the impact of the fluid challenge technique on diagnosis of fluid responsiveness? A systematic review and meta-analysis.
DOI:
https://doi.org/10.30445/rear.v10i6.445Keywords:
fluid reanimation, fluid therapy, fluid response capacity, fluid testAbstract
The purpose of this study was to describe the ‘charge of volume’ and evaluate the difference in proper proportion for ‘responders’ (PR) according the type of liquid, volume, the timing of infusion and the moment of evaluation.
Methods: Medline and Embase searches were made for studies using charge of volumen as a cardiac precharge test among a technique description, fluid response capacities reported definition and PR. Primary results were average PR, according liquid volumen, liquid type, infusion ratio and time for evaluation.
Results: A total of 85 studies (3,601 patients) for the analysis. PR were 54.4% (IC 95% 46.9-62.7) where <500 ml was administrated 57.2% (IC 95% 52.9-61.0) where 500 ml was administrated and 60.5% (IC 95% 35.9-79.2) where >500 ml was administrated (p=0.71). PR was not influenced by the type of fluid. RP was similar among patients given a charge of volumen during <15 minutes (59.2%, IC 95% 54.2-64.1) and during 15-30 minutes (57.7%, IC 95% 52.4-62.4, p = 1). In time of infusion ≥30 minutes, a lesser 49.9% (IC 95% 45.6-54, p = 0.04) PR happened. Response was evaluated at the end of fluid exposure between 1 and 10 minutes, and <10 minutes after fluid exposure. Responder´s proportion was 53.9%, 57.7% y 52.3% (p=0.47).
Findings: PR decreases in a long infusion time. Standardise charge of volumen is desirable.
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