From: The haemodynamic dilemma in emergency care: Is fluid responsiveness the answer? A systematic review
Author | Participants | Intervention | Criterion standard (FR definition) | Rate of FR (%) | SN | SP | AUC | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Inclusion criteria | No. | Disease severity | Base BP | Base Lactate | Spont. breathing | Dynamic test | Monitor | Parameter measured | Cutoff | ||||||
Corl38 | Age ≥18, clinically expected to be eu- or hypovolaemic | 26 | N/A | SBP 114 | N/A | Yes | PLR | U/S | ∆ Caval index | N/A | ≥10% increase in CI by TEB 4 min after PLR | 31 | N/A | N/A | 0.56 (0.31–0.81) |
Duus41 | Age ≥18 and decided to receive a fluid bolus | 109 (100 were analysed) | APACHE II 5 ± 3.6 | MAP 126 ± 19 | 1.4 ± 0.6 | Yes | PLR | Bioreactance | ∆SV | 10% | ≥10% increase in SV by bioreactance after a fluid bolus (at least 5 ml/kg – no pre-defined infusion time or time frame for assessment) | 60 | 80% (72%-88%) | 61% (51%-71%) | N/A |
de Valk39 | At least one clinical sign of shock and decided to receive a fluid bolus | 52 (45 were analysed) | N/A | MAP 73.8 ± 14.2 | 1,9 ± 1.1 | Yes | Spontaneous breathing | U/S | Caval Index | 36.5% (Not pre-defined) | ≥10 mmHg increase in BP 15 min after a fluid bolus (500 ml NaCl 0.9% over 15 min) | 27 | 83% | 67% | 0.741 |
Feissel40 | Age ≥18, mechanically ventilated, sinus rhythm and septic shock | 39 (31 were analysed) | SOFA 14 ± 2 | 72 ± 19* | N/A | No | MV | Plethysmography | Plethysmographic variability index (PVI) | 19% (Not pre-defined) | ≥15% increase in VTI by TTE 5 min after a fluid bolus (8 mL/kg HES over 20 min) | 52 | 94% (69%-100%) | 87% (61%-97%) | 0.97 (0.83-0.99) |
Jung42 | Spontaneous breathing, sepsis-induced hypotension | 26 (22 were analysed) | N/A | N/A | N/A | Yes | None | Oesophageal Doppler | Baseline corrected flow time (FTc) | 301 ms (Not pre-defined) | ≥10% increase in SVI by oesophageal Doppler immediately after a fluid bolus (7 mL/kg HES over 30 min) | 65 | 88.2% | 88.8% | 0.870 (0.708–0.979) |