RT Journal Article
T1 Pharmacodynamic analysis of a fluid challenge with 4 ml kg-1 over 10 or 20 min: a multicenter cross-over randomized clinical trial.
A1 Messina, Antonio
A1 Palandri, Chiara
A1 De Rosa, Silvia
A1 Danzi, Vinicio
A1 Bonaldi, Efrem
A1 Montagnini, Claudia
A1 Baino, Sara
A1 Villa, Federico
A1 Sala, Francesca
A1 Zito, Paola
A1 Negri, Katerina
A1 Della Corte, Francesco
A1 Cammarota, Gianmaria
A1 Saderi, Laura
A1 Sotgiu, Giovanni
A1 Monge García, Manuel Ignacio
A1 Cecconi, Maurizio
K1 Fluid challenge
K1 Fluid responsiveness
K1 Fluids
K1 Hemodynamics
K1 Neurosurgery
K1 Pharmacodynamic
AB A number of studies performed in the operating room evaluated the hemodynamic effects of the fluid challenge (FC), solely considering the effect before and after the infusion. Few studies have investigated the pharmacodynamic effect of the FC on hemodynamic flow and pressure variables. We designed this trial aiming at describing the pharmacodynamic profile of two different FC infusion times, of a fixed dose of 4 ml kg-1. Forty-nine elective neurosurgical patients received two consecutive FCs of 4 ml kg-1 of crystalloids in 10 (FC10) or 20 (FC20) minutes, in a random order. Fluid responsiveness was defined as stroke volume index increase ≥ 10%. We assessed the net area under the curve (AUC), the maximal percentage difference from baseline (dmax), time when the dmax was observed (tmax), change from baseline at 1-min (d1) and 5-min (d5) after FC end. After FC10 and FC20, 25 (51%) and 14 (29%) of 49 patients were classified as fluid responders (p = 0.001). With the exception of the AUCs of SAP and MAP, the AUCs of all the considered hemodynamic variables were comparable. The dmax and the tmax were overall comparable. In both groups, the hemodynamic effects on flow variables were dissipated within 5 min after FC end. The infusion time of FC administration affects fluid responsiveness, being higher for FC10 as compared to FC20. The effect on flow variables of either FCs fades 5 min after the end of infusion.
YR 2021
FD 2021-09-08
LK https://hdl.handle.net/10668/25022
UL https://hdl.handle.net/10668/25022
LA en
DS RISalud
RD Apr 7, 2025