Positive fluid responsiveness was defined as an increase of SV >15% after the fluid challenge (500 mL of gelatine infusion over 20 min) Threshold values were identified as matching values with highest sensitivity and values with highest specificity.
Interestingly, there was also a significant increase in the MAP after PLR, and this response exceeded the increase in the MAP after the fluid challenge (Tables 2 and 3).
Patients were included if they (1) had a systolic arterial pressure ≤90 mmHg (or a ≥40 mmHg reduction in systolic arterial pressure in known hypertensive patients) and at least one of the following signs: urinary flow ≤0.5 ml.kg [sup]−1.min [sup]−1 for ≥2 h, tachycardia ≥100 beats/min, or skin mottling; and (2) required fluid challenge, as determined by the attending physician.
Fluid responsiveness was defined as a ≥15% increase in CO after fluid challenge when compared with baseline CO.
The variables were recorded during five mini fluid challenges
in each of the 48 pre- and 48 post-operative mVLT sessions.
induced plasma dilution (PD) during the mVLT is calculated from a change of hemoglobin concentration (Hb).
A variable was regarded as a predictor of fluid responsiveness if its baseline value correlated with the change in stroke volume associated with fluid challenge
Goal directed fluid therapy (GDFT) implies stepwise fluid administration (fluid challenges
) guided by the flow-related parameters ranging from arterial blood pressure (ABP) to cardiac stroke volume.
The principal benefit of predicting haemodynamic response to fluid challenge
is avoiding ineffective and potentially deleterious fluid loading.
The essential of PLR is to assist the physician to identify fluid responsiveness, which is equal to the fluid challenge
. Hypotension is the most common indication to trigger the fluid challenge
Evaluation of plasma dilution is performed by measuring haemoglobin concentration (Hb) before and after each mini fluid challenge
. Imminent oedema is suspected when the ability of a mini fluid challenge
to advance haemodilution is minimised (approaches zero) .
Following twice fluid challenge
tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group.
OAK SIGNATURE addresses the rigorous fluid challenges
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Although regional flow of the superior mesenteric artery and celiac trunk axes increased after fluid challenges
, they still did not return to baseline.