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Table 3 Physiological effects grouped by measurement time

From: Physiological changes after fluid bolus therapy in sepsis: a systematic review of contemporary data

First author Fluid given Group Time from completion of fluid administration until physiological measurement (minutes) Measure of central tendency Change in cardiac output estimation Change in heart rate (bpm) Change in mean arterial pressure (mmHg)) Change in central venous pressure (mmHg) Change in venous oxygen saturation (%) Change in blood lactate concentration (mmol/l) Change in urine output Change in haemoglobin concentration (g/L)
Haemodynamic indices measured immediately following fluid bolus administration
Machare-Delgado [48] 500 ml of 0.9% saline over 10 minutes Responders: >10% SVI increase 0 Mean +3.99 ml/m2/beat        
  500 ml of 0.9% saline over 10 minutes Non-responders: >10% SVI increase 0 Mean +0.57 ml/m2/beat        
Dong [39] 500 ml of 6% HES over 30 minutes Responders: >15% SVI increase 0 Mean +600 ml/min/m2 -1.5 +15.2 +3.2     
  500 ml of 6% HES over 30 minutes Non-responders: <15% SVI increase 0 Mean +300 ml/min/m2 -1.2 +4.8 +2.3     
Khwannimit [45] 500 ml of 6% HES over 30 minutes Responders: >15% SVI increase 0 Mean +1300 ml/min/m2 -3.3 +9.5 +3.4     
  500 ml of 6% HES over 30 minutes Non-responders: <15% SVI increase 0 Mean +200 ml/min/m2 -0.9 +3.9 +5.2     
Lakhal [46] 500 ml of 4% gelatin over 30 minutes Responders: >15% SVI increase 0 Mean +900 ml/min/m2 -6 +14 +3     
  500 ml of 4% gelatin over 30 minutes Non-responders: <15% SVI increase 0 Mean +0 ml/min/m2 -3 +7 +4.5     
Mahjoub [50] 500 ml of 0.9% saline over 20 minutes Responders: >10% SV increase 0 Mean +1,000 ml/min -4 +7 +2.6     
  500 ml of 0.9% saline over 20 minutes Non-responders: >10% SV increase 0 Mean +300 ml/min -3 +1 +2.9     
Monnet [53] 500 ml of 0.9% saline over 10 minutes All patients 0 Mean +800 ml/min/m2 -7 +8 +5     
Monnet [55] 500 ml of 0.9% saline over 20 minutes Responders: >15% CI increase 0 Mean +800 ml/min/m2 -2 +11      
  500 ml of 0.9% saline over 20 minutes Non-responders: <15% increase in CI 0 Mean +200 ml/min/m2 -2 +4      
Monnet [54] 500 ml of 0.9% saline over 30 minutes Responders: >15% VO2 increase 0 Mean +1,000 ml/min/m2 -2 +7   +1% -1.9   -7
  500 ml of 0.9% saline over 30 minutes Non-responders: <15% increase in VO2 0 Mean +1,000 ml/min/m2 +0 +13   +7% -0.3   -6
Schnell [62] 500 ml of 0.9% saline over 15-30 minutes Responders: >10% increase in aortic blood flow 0 Median +20 ml/beat -10 +7      
  500 ml of 0.9% saline over 15-30 minutes Non-responders: <10% increase in aortic blood flow 0 Median +8 ml/beat -1 +6      
Sturgess [63] 250 ml of 4% albumin over 15 minutes All patients 0 Mean +7.5% ml/beat        
Haemodynamic indices measured 30 minutes after fluid bolus administration
Freitas [40] 7 ml/kg, maximum 500 ml, of 6% HES over 30 minutes Responders: >15% CO increase 30 Mean +2,100 ml/min -2 +11 +3 +8% -0.1   
  7 ml/kg, maximum 500 ml, of 6% HES over 30 minutes Non-responders: <15% increase in CO 30 Mean +200 ml/min +0 +8 +5 -3.5% -0.2   
Pierrakos [59] 500 ml of 6% HES or 1,000 ml of CSL over 30 minutes Responders: >10% increase in CI 30 Mean +600 ml/min/m2 -4 +8 +3 +3%    
  500 ml of 6% HES or 1,000 ml of CSL over 30 minutes Non-responders: <10% increase in CI 30 Mean +0 ml/min/m2 -4 +3 +2 +0%    
Pottecher [60] Up to 500 ml of 6% HES or 0.9% saline over 30 minutes All patients 30 Mean +1,400 ml/min -2 +7      
Wacharasint [66] 500 ml of 6% HES over 30 minutes All patients 30 Mean +470 ml/min/m2 +0.3 +9.2 +5.25     
van Haren [65] 250 ml of 6% HES in 7.2% saline over 15 minutes Hypertonic bolus 30 Mean +300 ml/min/m2 -11 +4 +2   -0.2   -8
  500 ml of 6% HES in 0.9% saline over 15 minutes Isotonic bolus 30 Mean -400 ml/min/m2 -1 +5 +4   -0.1   -9
Haemodynamic indices measured 60 minutes after fluid bolus administration
Bihari [36] 500-750 ml of 4% albumin, blood, 20% albumin FFP, 0.9% saline, 4% gelatin or platelets administered over less than 30 minutes All patients 60 Median   +0 +2 +2 +0.4% -0.2 No change -6
Ospina-Tascon [57] 400 ml of 4% albumin or 1,000 ml of CSL over 30 minutes Patients with early sepsis 60 Median +300 ml/min/m2 +2 +2 +3 +2% -0.2   
  400 ml of 4% albumin or 1,000 ml of CSL over 30 minutes Patients with late sepsis 60 Median +300 ml/min/m2 -9 +7 +1 +1% +0.1   
van Haren [65] 250 ml of 6% HES in 7.2% saline over 15 minutes Hypertonic bolus 60 Mean +400 ml/min/m2 -11 +6 +1   -0.3   -9
  500 ml of 6% HES in 0.9% saline over 15 minutes Isotonic bolus 60 Mean -300 ml/min/m2 -1 +3 +3   -0.1   -12
Haemodynamic indices measured greater than 60 minutes after fluid bolus administration
van Haren [65] 250 ml of 6% HES in 7.2% saline over 15 minutes Hypertonic bolus 120 Mean +300 ml/ml/m2 -7 +7 +2   0.0 +13 -6
  500 ml of 6% HES in 0.9% saline over 15 minutes Isotonic bolus 120 Mean -300 ml/min/m2 +0 +1 +2   -0.3 -30 -9
  250 ml of 6% HES in 7.2% saline over 15 minutes Hypertonic bolus 180 Mean +100 ml/min/m2 -3 +6 +3   -0.3   -9
  500 ml of 6% HES in 0.9% saline over 15 minutes Isotonic bolus 180 Mean +0 ml/min/m2 +3 +5 +3   -0.2   -6
  250 ml of 6% HES in 7.2% saline over 15 minutes Hypertonic bolus 240 Mean +100 ml/min/m2 +1 +3 +3   -0.3 -3 -8
  500 ml of 6% HES in 0.9% saline over 15 minutes Isotonic bolus 240 Mean -200 ml/min/m2 +3 +0 +3   -0.2 -40 -4
  1. CI, cardiac index; CO, cardiac output; CSL, compound sodium lactate; FFP, fresh frozen plasma; HES, hydroxyethyl starch; SVI, stroke volume index; VO2, oxygen delivery.