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

Glassford, Neil J; Eastwood, Glenn M; Bellomo, Rinaldo

doi:10.1186/s13054-014-0696-5

Critical Care

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

CI, cardiac index; CO, cardiac output; CSL, compound sodium lactate; FFP, fresh frozen plasma; HES, hydroxyethyl starch; SVI, stroke volume index; VO₂, oxygen delivery.

Back to article page

ISSN: 1364-8535

Contact us

Submission enquiries: journalsubmissions@springernature.com