From: Physiological changes after fluid bolus therapy in sepsis: a systematic review of contemporary data
First author | Year | Initial resuscitation | Bolus fluid type | Bolus fluid volume (ml) | Bolus fluid rate (minutes) | Physiological trigger for fluid administration | Physiological end-point for fluid administration | Number of boluses administered | Vasoactive administration? | Packed red cell transfusion? |
---|---|---|---|---|---|---|---|---|---|---|
Bihari [36] | 2013 | Undefined | 4% albumin | 750 | <30 | Clinician defined | Clinician defined | 2 | Yes | Not described |
Packed red cells | ||||||||||
20% albumin | ||||||||||
Fresh frozen plasma | ||||||||||
4% gelatin | ||||||||||
0.9% saline | ||||||||||
Castellanos-Ortega [37] | 2010 | Undefined | Crystalloid | 1,000 | 30 | Hypotension | CVP ≥8 mmHg, MAP ≥65 mmHg, ScvO2 ≥ 70% | Not described | Yes | Not described |
Colloid | 500 | |||||||||
De Backer [38] | 2010 | 500Â ml colloid or 1,000Â ml crystalloid | Crystalloid | 1,000 | Not defined | MAP <70Â mmHg; SBP <100Â mmHg, altered mental state; mottled skin; oliguria >1Â hour, hyperlactataemia | Not described | Not described | Yes | Not described |
Colloid | 500 | |||||||||
Dong [39] | 2012 | Undefined | 6% HES | 500 | 30 | SBP <90Â mmHg or >40Â mmHg drop or need for vasopressors, oliguria >1Â hour; mottled skin; HR >100Â bpm | End of infusion. | 1 | Not described | Not described |
Freitas [40] | 2012 | Undefined | 6% HES | 7Â ml/kg (max 500) | 30 | Clinician defined | End of infusion | 1 | Yes | No |
Gaieski [41] | 2010 | 20-30Â ml/kg | 0.9% saline | 500 | 15-20 | CVP <8Â mmHg | CVP >8Â mmHg | Not described | Yes | Yes |
Hamzaoui [42] | 2010 | Undefined | 0.9% saline | 1,000 | Not defined | Undefined | Not described | Not described | Yes | Not described |
Hanzelka [43] | 2013 | 20Â ml/kg | Undefined | 1,000 | 60 | Severe sepsis | SBP >90Â mmHg, MAP <65Â mmHg | Not described | Yes | No |
500 | 30 | |||||||||
Jacob [44] | 2012 | Undefined | 0.9% saline | 1,000 | 60 | SBP <100Â mmHg or hyperlactataemia | SBP increased by 10Â mmHg for 2 consecutive hours to >90Â mmHg | Up to 10 | No | Not described |
500 | 30 | |||||||||
Khwannimit [45] | 2012 | Undefined | 6% HES | 500 | 30 | Clinician defined | End of infusion | 1 | Yes | Not described |
Lakhal [46] | 2013 | Undefined | 4% gelatin | 500 | 30 | One or more of SBP <90Â mmHg, MAP <65Â mmHg , requiring vasoactive medication, oliguria, skin mottling, hyperlactataemia | End of infusion | 1 | Yes | Not described |
Lanspa [47] | 2012 | 5,060Â ml | Crystalloid (or equivalent colloid) | 20Â ml/kg | <20 | Clinician defined | End of infusion | 1.36 | Yes | Yes |
Machare-Delgado [48] | 2011 | Undefined | 0.9% saline | 500 | 10 | Clinician defined | End of infusion | 1 | Not described | No |
MacRedmond [49] | 2010 | 25 ml/kg | 0.9% saline | 500 | <15 | MAP <65 mmHg | CVP 8-12; MAP >65 mmHg; ScvO2 > 70% | Not described | Yes | Yes |
Mahjoub [50] | 2013 | Undefined | 0.9% saline | 500 | 20 | SBP <90Â mmHg and/or need for vasoactive drugs and/or persistent lactic acidosis | End of infusion | 1 | Yes | Not described |
McIntyre [51] | 2012 | 2,400Â ml | 0.9% saline or 4% albumin | 500 | STAT | Undefined | Not described | 6 | Yes | Not described |
Monnet [52] | 2010 | Undefined | 0.9% saline | 500 | 30 | SBP <90Â mmHg, SBP drop >50Â mmHg if HT, and one or more of HR >100, skin mottling or oliguria | End of infusion | 1 | Yes | Not described |
Monnet [53] | 2011 | 2,200Â ml | 0.9% saline | 500 | 10 | SBP <90Â mmHg, SBP drop >50Â mmHg if HT, and one or more of HR >100, skin mottling or oliguria | End of infusion | 1 | Yes | Not described |
Monnet [54] | 2013 | Undefined | 0.9% saline | 500 | 30 | SBP <90Â mmHg, SBP drop >50Â mmHg if HT, and one or more of HR >100, skin mottling or oliguria | End of infusion | 1 | Yes | Yes |
Monnet [55] | 2011 | Undefined | 0.9% saline | 500 | 20 | SBP <90Â mmHg, SBP drop >50Â mmHg if HT, and one or more of HR >100, skin mottling or oliguria | End of infusion | 1 | Yes | Not described |
O’Neill [56] | 2012 | 20 ml/kg | 0.9% saline | 500 | 15 | CVP <8 mmHg; MAP <65 mmHg; ScvO2 < 70% | CVP 8-12; MAP >65 mmHg; ScvO2 > 70% | 0.68 | Yes | Not described |
Ospina-Tascon [57] | 2010 | Undefined | CSL | 1,000 | 30 | MAP <65Â mmHg | End of infusion | 1 | Yes | Not described |
4% albumin | 400 | |||||||||
Patel [58] | 2010 | 2,000Â ml | Normal saline | Undefined | 30 | SBP <90Â mmHg; MAP <65Â mmHg | Not described | 1 | Yes | Not described |
Pierrakos [59] | 2012 | Undefined | CSL | 100 | 30 | Clinician defined | End of infusion | 1 | Yes | Not described |
6% HES | 500 | |||||||||
Pottecher [60] | 2010 | Undefined | HES 6% or 0.9% saline | 500 | 30 | MAP <65Â mmHg, skin mottling or oliguria | End of infusion | 1 | Yes | Not described |
Sanchez [61] | 2011 | Undefined | Crystalloid | 1,000 | Undefined | Hypotension with perfusion abnormalities | Â | Not described | Yes | No |
Colloid | 500 | ITBVI >900Â ml/ml or EVLWI >10Â ml/kg | ||||||||
Schnell [62] | 2013 | Undefined | 0.9% saline | 500 | 15-30 | Clinician defined | End of infusion | 1 | Yes | Not described |
Sturgess [63] | 2010 | Undefined | 4% albumin | 250 | 15 | Clinician defined | End of infusion | 1 | Yes | No |
Trof [64] | 2012 | Undefined | HES or 4% gelatin | 250-500 | 30 | EVLWI <10 ml/kg or >10 ml/kg with GEDVI <850 ml/m2; PAOP >18 mmHg; MAP <65 mmHg, HR >100, SvO2 < 65% or ScvO2 < 70%; oliguria; peripheral perfusion deficits, hyperlactatemia | MAP >65 mmHg, ScvO2 > 70%, lactate clearance, diuresis >0.5 ml/kg/hour, restoration of peripheral perfusion deficits | 3.48 | Yes | Not described |
van Haren [65] | 2012 | Undefined | 6% HES in 0.9% saline | 500 | 15 | Septic shock | End of infusion | 1 | Yes | Not described |
250 | 15 | |||||||||
6% HES in 7.2% saline | ||||||||||
Wacharasint [66] | 2013 | Undefined | HES 6% | 500 | 30 | SBP <90Â mmHg or requirement for vasopressors | End of infusion | 1 | Yes | Not described |
Yu [67] | 2011 | 30 ml/kg in 1,000 ml increments | Crystalloid or colloid | 250-500 | Undefined | PAOP <12 mmHg or 12-17 mmHg with | SBP >100 mmHg, HR <100 bpm, UO >0.5 ml/kg/hour, lactate clearance, SmvO2 > 70% | Not described | Not described | Yes |
SBP <100; HR >100 bpm UO <0.5 ml/kg/hour; hyperlactataemia; SvO2 > 70% or equivalent blood volume goals | ||||||||||
Zhang [68] | 2012 | Undefined | Crystalloid or colloid | 250-500 | 30 | SBP <90Â mmHg; HR >100Â bpm; GEDVI <700Â ml/m2; CVP <12Â mmHg (PEEP dependent) | Pre-defined rise in CVP | Not described | Yes | Not described |