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Table 2 Description of fluid boluses, triggers, physiological end-points and primary confounders

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 500 ml colloid or 1,000 ml crystalloid Crystalloid 1,000 Not defined MAP <70 mmHg; SBP <100 mmHg, altered mental state; mottled skin; oliguria >1 hour, hyperlactataemia Not described Not described Yes Not described
Colloid 500
Dong [39] 2012 Undefined 6% HES 500 30 SBP <90 mmHg or >40 mmHg drop or need for vasopressors, oliguria >1 hour; mottled skin; HR >100 bpm End of infusion. 1 Not described Not described
Freitas [40] 2012 Undefined 6% HES 7 ml/kg (max 500) 30 Clinician defined End of infusion 1 Yes No
Gaieski [41] 2010 20-30 ml/kg 0.9% saline 500 15-20 CVP <8 mmHg CVP >8 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 20 ml/kg Undefined 1,000 60 Severe sepsis SBP >90 mmHg, MAP <65 mmHg Not described Yes No
500 30
Jacob [44] 2012 Undefined 0.9% saline 1,000 60 SBP <100 mmHg or hyperlactataemia SBP increased by 10 mmHg for 2 consecutive hours to >90 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 <90 mmHg, MAP <65 mmHg , requiring vasoactive medication, oliguria, skin mottling, hyperlactataemia End of infusion 1 Yes Not described
Lanspa [47] 2012 5,060 ml Crystalloid (or equivalent colloid) 20 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 <90 mmHg and/or need for vasoactive drugs and/or persistent lactic acidosis End of infusion 1 Yes Not described
McIntyre [51] 2012 2,400 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 <90 mmHg, SBP drop >50 mmHg if HT, and one or more of HR >100, skin mottling or oliguria End of infusion 1 Yes Not described
Monnet [53] 2011 2,200 ml 0.9% saline 500 10 SBP <90 mmHg, SBP drop >50 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 <90 mmHg, SBP drop >50 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 <90 mmHg, SBP drop >50 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 <65 mmHg End of infusion 1 Yes Not described
4% albumin 400
Patel [58] 2010 2,000 ml Normal saline Undefined 30 SBP <90 mmHg; MAP <65 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 <65 mmHg, skin mottling or oliguria End of infusion 1 Yes Not described
Sanchez [61] 2011 Undefined Crystalloid 1,000 Undefined Hypotension with perfusion abnormalities   Not described Yes No
Colloid 500 ITBVI >900 ml/ml or EVLWI >10 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 <90 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 <90 mmHg; HR >100 bpm; GEDVI <700 ml/m2; CVP <12 mmHg (PEEP dependent) Pre-defined rise in CVP Not described Yes Not described
  1. CSL, compound sodium lactate solution; CVP, central venous pressure; EVLWI, extra-vascular lung water index; HES, hydroxyethyl starch; HR, heart rate; HT, hypertensive; GEDVI, global end diastolic volume index; ITBVI, intrathoracic blood volume index; MAP, mean arterial blood pressure; PAOP, pulmonary artery occlusion pressure; PEEP, positive end-expiratory pressure; SBP, systolic blood pressure; ScvO2, central venous oxygen saturation; SmvO2, mixed venous oxygen saturations; STAT, statim/immediately; SvO2, venous oxygen saturation; UO, urine output.