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2020, Number 1

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Mediciego 2020; 26 (1)

Fluid administration in critically ill patients

Moyano-Alfonso I, González-Alvarez A, Fernández-Hernández JA

Language: Spanish
References: 56
Page: 1-22
PDF size: 508.16 Kb.


ABSTRACT

Introduction: the administration of fluids constitutes one of the fundamental pillars in the treatment of seriously ill patients; only 50 % respond to this procedure and there is an inconsistency between macro and microhemodynamic variables, which makes monitoring more complex. Current research focuses on multiple monitoring variables and various strategies for fluid administration in the critically ill patient.
Objective: to update the evidence on the administration of fluids in the seriously ill patient.
Methods: the studies published in the PubMed, SciELO Cuba, Cumed databases and in the Google Academic search engine were reviewed. The papers published in the last five years, in English and Spanish languages, were selected.
Development: evidences related to the variables of monitoring for the administration of fluids, and strategies for its maintenance are presented. In this regard, the authors present their critical considerations.
Conclusions: there is a consensus that the initial administration of fluids in patients in shock should be early and aggressive to restore blood volume. Fluid administration needs monitoring variables to effectively define the patient who benefits from its use, taking into account that the signs of the physical examination, the most common physiological variables, and the radiographic study are not very effective in guiding their contribution. Despite the evidence that fluid overload worsens the patient's prognosis, there is still no consensus regarding volume maintenance in critically ill patients. Therefore, new studies are required to address this issue.


REFERENCES

  1. Reddy S, Weinberg L, Young P. Crystalloid fluid therapy. J Crit Care [Internet]. 2016 [citado 12 Feb 2018];20(59):[aprox. 9 p.]. Disponible en: https://ccforum.biomedcentral.com/track/pdf/10.1186/s13054-016-1217-5

  2. Marik PE, Monnet X, Teboul JL. Hemodynamic parameters to guide fluid therapy. Ann. Intensive Care [Internet]. 2011 [citado 12 Feb 2018];1(1):[aprox. 9 p.] Disponible en: https://link.springer.com/content/pdf/10.1186/2110-5820-1-1.pdf

  3. Monnet X, Teboul JL. Assessment of volume responsiveness during mechanical ventilation: recent advances. J Crit Care [Internet]. 2013 [citado 12 Feb 2018];17(217):[aprox. 7 p.]. Disponible en: https://link.springer.com/content/pdf/10.1186/cc12526.pdf

  4. Marik PE, Monnet X, Teboul J. Hemodynamic parameters to guide fluid therapy. Transf Med [Internet]. 2010 [citado 12 Feb 2018];11(3):102-12. Disponible en: https://cyberleninka.org/article/n/170561.pdf

  5. Haun-De Oliveira O, Rezende-De Freitas FG, Texeira-Ladeira R, Fischer CH, Tonete-Bafi A, Pontes-Azevedo LC, et al. Comparison between respiratory changes in the inferior vena cava diameter and pulse pressure variation to predict fluid responsiveness in postoperative patients. J Crit Care [Internet]. 2016 [citado 12 Feb 2018];34:46-9. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S088394411630017X.pdf?locale=es_ES&searchIndex=

  6. Diaztagle-Fernández JJ, Cruz-Martínez LE, Caicedo-Ruiz JD. La prueba de líquidos en sepsis severa y choque séptico: una mirada desde la fisiología. Acta Colomb Cuid Intensivo [Internet]. 2015 [citado 12 Feb 2018];15(3):204-14. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0122726215000221.pdf?locale=es_ES&searchIndex=

  7. Yunfan W, Shusheng Z, Zhihua Z, Bao L. A 10-second fluid challenge guided by transthoracic echocardiography can predict fluid responsiveness. J Crit Care [Internet]. 2014 [citado 12 Feb 2018];18(3):[aprox. 8 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075154/pdf/cc13891.pdf

  8. Hernández-Sómerson MA, Bernal-Ramírez O, Jiménez-Palomino JC, Rodriguez-Urueña S, Jurado-Zambrano JR, Montoya-Agudelo F. Terapia temprana dirigida por metas en sepsis: ¿es momento para un nuevo algoritmo? Acta Colomb Cuid Intensivo [Internet]. 2016 [citado 12 Feb 2018];16(4):283-9. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0122726216300350.pdf?locale=es_ES&searchIndex=

  9. Zochios V, Wilkinson J. Assessment of intravascular fluid status and fluid responsiveness during mechanical ventilation in surgical and intensive care patients. J Intensive Care Soc [Internet]. 2011 [citado 12 Feb 2018];12(4):295-300. Disponible en: https://journals.sagepub.com/doi/pdf/10.1177/175114371101200410

  10. Peake S, Delaney A, Bailey M, Bellomo R, Cameron PA, Cooper J, et al. Goal-directed resuscitation for patients with early septic shock. N Engl J Med [Internet]. 2014 [citado 12 Feb 2018];371(16):1496-1506. Disponible en: https://www.nejm.org/doi/pdf/10.1056/NEJMoa1404380

  11. Donald MY, Kellum JA, Huang DT, Barnato AE, Weissfeld LA, Pike F, et. al. A randomized trial of protocol-based care for early septic shock. N Engl J Med [Internet]. 2014 [citado 12 Feb 2018];370(18):1683-93. Disponible en: https://www.nejm.org/doi/pdf/10.1056/nejmoa1401602

  12. Mouncey PR, Osborn TM, Power S, Harrison DA, Sadique MZ, Grieve RD, et al. Trial of early, goal directed resuscitation for septic shock. N Engl J Med [Internet]. 2015 [citado 12 Feb 2018];372(14):1301-11. Disponible en: https://www.nejm.org/doi/pdf/10.1056/NEJMoa1500896

  13. Maitland K, George EC, Evans JA, Kiguli S, Olupot P, Akech SO, et al. Exploring mechanisms of excess mortality with early fluid resuscitation: insights from the FEAST trial. BMC Med [Internet]. 2013 [citado 12 Feb 2018];11(68):[aprox. 15 p.]. Disponible en: https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/1741-7015-11-68

  14. Hanson J, Lam SW, Shansul A, Pattnaik R, Mahanta K, Uddin-Hasan M, et al. The reliability of the physical examination to guide fluid therapy in adults with severe falciparum malaria: an observational study. Malar J [Internet]. 2013 [citado 12 Feb 2018];12(348):[aprox. 9 p.]. Disponible en: https://malariajournal.biomedcentral.com/track/pdf/10.1186/1475-2875-12-348

  15. Soliman RA, Samir S, El Naggar A, El Dehely K. Stroke volume variation compared with pulse pressure variation and cardiac index changes for prediction of fluid responsiveness in mechanically ventilated patients. Egypt J Crit Care Med [Internet]. 2015 [citado 12 Feb 2018];3(1):9-16. Disponible en: https://www.sciencedirect.com/science/article/pii/S2090730315000031?via%3Dihub

  16. Hasanin A. Fluid responsiveness in acute circulatory failure. J Intensive Care [Internet]. 2015 [citado 12 Feb 2018];3(50):[aprox. 8 p.]. Disponible en: https://jintensivecare.biomedcentral.com/track/pdf/10.1186/s40560-015-0117-0

  17. Maas J. Mean systemic filling pressure: from Guyton to the ICU. [Internet]. Leiden: UFB/Grafische Producties; 2013 [citado 12 Feb 2018]. Disponible en: https://openaccess.leidenuniv.nl/bitstream/handle/1887/20407/Thesis%20book.pdf?sequence=3

  18. Berlin DA, Bakker J. Starling curves and central venous pressure. J Crit Care [Internet]. 2015 [citado 12 Feb 2018];19(55):[aprox. 7 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329649/pdf/13054_2015_Article_776.pdf

  19. Grassi P, Lo Nigro L, Battaglia K, Barone M, Testa F, Berlot G. Pulse pressure variation as a predictor of fluid responsiveness in mechanically ventilated patients with spontaneous breathing activity: a pragmatic observational study. HSR Proc Intensive Care Cardiovasc Anesth [Internet]. 2013 [citado 12 Feb 2018];5(2):98-109. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722341/pdf/hsrp-05-098.pdf

  20. Sasai T, Tokioka H, Fukushima T, Mikane T, Oku S, Iwasaki E, et al. Reliability of central venous pressure to assess left ventricular preload for fluid resuscitation in patients with septic shock. J Int Care [Internet]. 2014 [citado 12 Feb 2018];2(1):58. Disponible en: http://www.jintensivecare.com/content/2/1/58

  21. Pinsky MR. Functional hemodynamic monitoring. Crit Care Clin [Internet]. 2015 [citado 12 Feb 2018];31(1):89-111. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250574/pdf/nihms-626235.pdf

  22. Lakhal K, Ehrmann S, Runge I, Benzekri-Lefe D, Legras A, Dequin PF, et al. Central venous pressure measurements improve the accuracy of leg raising induced change in pulse pressure to predict fluid responsiveness. Int Care Med [Internet]. 2010 [citado 12 Feb 2018];36(6):940-8. Disponible en: https://link.springer.com/content/pdf/10.1007/s00134-010-1755-2.pdf

  23. Perel A. The physiological basis of arterial pressure variation during positive pressure ventilation. Reanimation [Internet]. 2005 [citado 12 Feb 2018];14(3):162-71. Disponible en: https://www.srlf.org/wp-content/uploads/2015/11/0505-Reanimation-Vol14-N3-p162_171.pdf

  24. Cannesson M, Aboy M, Hofer CK, Rehman M. Pulse pressure variation: where are we today? J Clin Monit Comput [Internet]. 2011 [citado 12 Feb 2018];25(1):45-56. Disponible en: http://www.academia.edu/download/44171380/Pulse_pressure_variation_Where_are_we_to20160328-20967-18n06xs.pdf

  25. Benes J, Chytra I, Altmann P, Hluchy M, Kasal E, Svitak R, et al. Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study. J Crit Care [Internet]. 2010 [citado 12 Feb 2018];14(R118):[aprox. 15 p.]. Disponible en: https://core.ac.uk/reader/205401784

  26. Biais M, Ehrmann S, Mari A, Conte B, Mahjoub Y, Desebbe O, et al. Clinical relevance of pulse pressure variations for predicting fluid responsiveness in mechanically ventilated intensive care unit patients: the grey zone approach. J Crit Care [Internet]. 2014 [citado 12 Feb 2018];18(587):[aprox. 11 p.]. Disponible en: https://ccforum.biomedcentral.com/track/pdf/10.1186/s13054-014-0587-9

  27. Vallee F, Richard JC, Mari A, Gallas T, Arsac E, Verlaan PS, et al. Pulse pressure variations adjusted by alveolar driving pressure to assess fluid responsiveness. Int Care Med [Internet]. 2009 [citado 12 Feb 2018];35(6):1004-10. Disponible en: https://link.springer.com/content/pdf/10.1007/s00134-009-1478-4.pdf

  28. Freitas FG, Bafi AT, Nascente AP, Assuncao M, Mazza B, Azevedo LC, et al. Predictive value of pulse pressure variation for fluid responsiveness in septic patients using lung-protective ventilation strategies. Br J Anaesth [Internet]. 2013 [citado 12 Feb 2018];110(3):402-8. Disponible en: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.953.7418&rep=rep1&type=pdf

  29. Li C, Lin FQ, Fu SK, Chen GQ, Yang XH, Zhu CY, et al. Stroke volume variation for prediction of fluid responsiveness in patients undergoing gastrointestinal surgery. Int J Med Sci [Internet]. 2013 [citado 12 Feb 2018];10(2):148-55. Disponible en: https://www.medsci.org/v10p0148.pdf

  30. Messina A, Colombo D, Cammarota G, De Lucia M, Cecconi M, Antonelli M, et al. Patient ventilator asynchrony affects pulse pressure variation prediction of fluid responsiveness. J Crit Care [Internet]. 2015 [citado 12 Feb 2018];30(5):1067-71. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0883944115003524.pdf?locale=es_ES&searchIndex=

  31. Lee JY, Park HY, Jung WS, Jo YY, Kwak HJ. Comparative study of pressure and volume controlled ventilation on stroke volume variation as a predictor of fluid responsiveness in patients undergoing major abdominal surgery. J Crit Care [Internet]. 2012 [citado 12 Feb 2018];27(5):531.e9-14. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0883944111004953.pdf?locale=es_ES&searchIndex=

  32. Feissel M, Teboul JL, Merlani P, Badie J, Faller JP, Bendjelid K. Plethysmographic dynamic indices predict fluid responsiveness in septic ventilated patients. Int Care Med [Internet]. 2007 [citado 12 Feb 2018];33(6):993-9. Disponible en: https://core.ac.uk/reader/159153662

  33. Masimo Corporation. Pleth variability index: a dynamic measurement to help assess physiology and fluid responsiveness. Technical Bulletin [Internet]. 2015 [citado 12 Feb 2018]:[aprox. 7 p.]. Disponible en: https://pdfs.semanticscholar.org/24ac/cffcadcaaee728c7d73b7784a3a78733a8eb.pdf?_ga=2.31891258.52722834.1594227773-715995037.1594227773

  34. Monnet X, Guerin L, Jozwiak M, Bataille A, Julien F, Richard C, et al. Pleth variability index is a weak predictor of fluid responsiveness in patients receiving norepinephrine. Br J Anaesth [Internet]. 2013 [citado 12 Feb 2018];110(2):207-13. Disponible en: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.455.7254&rep=rep1&type=pdf

  35. Cavallaro F, Sandroni C, Marano C, La Torre G, Mannocci A, De Waure CH, et al.Diagnostic accuracy of passive leg raising for prediction of fluid responsiveness in adults: systematic review and meta-analysis of clinical studies. Int Care Med [Internet]. 2010 [citado 12 Feb 2018];36(9):225-33. Disponible en: https://link.springer.com/content/pdf/10.1007%2F978-3-642-28270-6_42.pdf

  36. Jabot J, Teboul JL, Richard C, Monnet X. Passive leg raising for predicting fluid responsiveness: importance of the postural change. Int Care Med [Internet]. 2009 [citado 12 Feb 2018];35(1):85-90. Disponible en: https://link.springer.com/content/pdf/10.1007/s00134-008-1293-3.pdf

  37. Lafanechère A, Pène F, Goulenok C, Delahaye A, Mallet V, Choukroun G, et al. Changes in aortic blood flow induced by passive leg raising predict fluid responsiveness in critically ill patients. J Crit Care [Internet]. 2006 [citado 12 Feb 2018];10(R132):[aprox. 8 p.]. Disponible en: https://www.scienceopen.com/document_file/5e78bac5-6e18-499f-b54f-391da4c0fa83/PubMedCentral/5e78bac5-6e18-499f-b54f-391da4c0fa83.pdf

  38. Thiel SW, Kollef MH, Isakow W. Non-invasive stroke volume measurement and passive leg raising predict volume responsiveness in medical ICU patients: an observational cohort study. J Crit Care [Internet]. 2009 [citado 12 Feb 2018];13(R111):[aprox. 7 p.]. Disponible en: https://ccforum.biomedcentral.com/track/pdf/10.1186/cc7955

  39. Monnet X, Bataille A, Magalhaes E, Barrois J, Le Corre M, Gosset C, et al. End-tidal carbon dioxide is better than arterial pressure for predicting volume responsiveness by the passive leg raising test. Int Care Med [Internet]. 2013 [citado 12 Feb 2018];39(1):93-100. Disponible en: http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=22990869&S=R&D=mdc&EbscoContent=dGJyMNLe80Seprc4yOvqOLCmsEieprZSs6a4S66WxWXS&ContentCustomer=dGJyMPGnr06vr7JJuePfgeyx44Dt6fIA

  40. Monge-García MI, Gil-Cano A, Gracia-Romero M, Monterroso-Pintado R, Pérez-Madueño V, Díaz-Monrovéet JC. Non-invasive assessment of fluid responsiveness by changes in partial end-tidal CO2 pressure during a passive leg-raising maneuver. Ann Intensive Care [Internet]. 2012 [citado 12 Feb 2018];2(9):[aprox. 9 p.]. Disponible en: https://link.springer.com/content/pdf/10.1186/2110-5820-2-9.pdf

  41. Zang ZD, Yan J, Xu HY, Liang FM, Yang T, Wang DP, et al. The value of changes in end-tidal carbon dioxide pressure induced by passive leg raising test in predicting fluid responsiveness in mechanically ventilated patients with septic shock. Zhonghua Nei Ke Za Zhi [Internet]. 2013 [citado 12 Feb 2018];52(8):646-50. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/24199878

  42. Boulain T, Garot D, Vignon P, Lascarrou JB, Desachy A, Botoc V, et al. Prevalence of low central venous oxygen saturation in the first hours of intensive care unit admission and associated mortality in septic shock patients: a prospective multicenter study. J Crit Care [Internet]. 2014 [citado 12 Feb 2018];18(609):[aprox 12 p.]. Disponible en: https://link.springer.com/content/pdf/10.1186/s13054-014-0609-7.pdf

  43. Meehan PA. Venous oximetry: indications and applications. TRENDS [Internet] Spring 2012 [citado 12 Feb 2018];317:[aprox. 8 p.]. Disponible en: https://www.yumpu.com/en/document/read/38944045/venous-oximetry-indications-and-applications

  44. Walley KR. Use of central venous oxygen saturation to guide therapy. Am J Respir Crit Care Med [Internet]. 2011 [citado 12 Feb 2018];184(5):514-20. Disponible en: https://crashingpatient.com/wp-content/uploads/2012/04/Use-of-central-venous-oxygen-saturation1.pdf

  45. Perz S, Uhlig T, Kohl M, Bredle DL, Reinhart K, Bauer M, et al. Low and ‘‘supranormal’’ central venous oxygen saturation and markers of tissue hypoxia in cardiac surgery patients: a prospective observational study. Int Care Med [Internet]. 2011[citado 12 Feb 2018];37(1):52-9. Disponible en: http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=20689932&S=R&D=mdc&EbscoContent=dGJyMNLe80Seprc4yOvqOLCmsEiep65Ssa24SrSWxWXS&ContentCustomer=dGJyMPGnr06vr7JJuePfgeyx44Dt6fIA

  46. Mikor A, Trásy D, Németh MF, Osztroluczki A, Kocsi Z, Kovács I, et al. Continuous central venous oxygen saturation assisted intraoperative hemodynamic management during major abdominal surgery: a randomized, controlled trial. BMC Anesthesiol [Internet]. 2015 [citado 12 Feb 2018];15(82):[aprox. 10 p.]. Disponible en: https://bmcanesthesiol.biomedcentral.com/track/pdf/10.1186/s12871-015-0064-2

  47. Bjerregaard LS, Moller Sorensen H, Lindskov K, Ravn J, Nilsson JC. Using clinical parameters to guide fluid therapy in high risk thoracic surgery. A retrospective, observational study. BMC Anesthesiol [Internet]. 2015 [citado 12 Feb 2018];15(91):[aprox. 7 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464224/pdf/12871_2015_Article_72.pdf

  48. Vallet B, Robin E, Lebuffe G. Venous oxygen saturation as a physiologic transfusion trigger. J Crit Care [Internet]. 2010 [citado 12 Feb 2018];14(213):[aprox. 5 p.]. Disponible en: https://core.ac.uk/download/pdf/8420401.pdf

  49. Bustos R, Padilla O. El tiempo de llene capilar prolongado es predictor de una saturación venosa central de oxígeno disminuida. Rev. chil. pediatr. [Internet]. 2014 [citado 12 Feb 2018];85(5):539-45. Disponible en: https://scielo.conicyt.cl/pdf/rcp/v85n5/art03.pdf

  50. Textoris J, Fouché L, Wiramus S, Antonini F, Tho S, Martin C, et al. High central venous oxygen saturation in the latter stages of septic shock is associated with increased mortality. J Crit Care [Internet]. 2011 [citado 12 Feb 2018];15(R176):[aprox.6 p.]. Disponible en: https://ccforum.biomedcentral.com/track/pdf/10.1186/cc10325

  51. Lichtenstein D, Karakitsos D. Integrating lung ultrasound in the hemodynamic evaluation of acute circulatory failure (the fluid administration limited by lung sonography protocol). J Crit Care [Internet]. 2012 [citado 12 Feb 2018];27(5):533e11-9. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0883944112001025.pdf?locale=es_ES&searchIndex=

  52. Marik PE, Lemson J. Fluid responsiveness: an evolution of our understanding. Br J Anaesth. [Internet]. 2014 [citado 12 Feb 2018];112(4):617-20. Disponible en: https://bjanaesthesia.org/action/showPdf?pii=S0007-0912%2817%2930874-7

  53. Barmparas G, Ko A, Harada MY, Zaw AA, Murry JS, Smith EJT, et al. Decreasing maintenance fluids in normotensive trauma patients may reduce intensive care unit stay and ventilator days. J Crit Care [Internet]. 2016 [citado 12 Feb 2018];31(1):201-5. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0883944115005298.pdf?locale=es_ES&searchIndex=

  54. Elofson KA, Eiferman DS, Porter K, Murphy CV. Impact of late fluid balance on clinical outcomes in the critically ill surgical and trauma population. J Crit Care [Internet]. 2015 [citado 12 Feb 2018];30(6):1338-43. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0883944115003767.pdf?locale=es_ES&searchIndex=

  55. Winther-Voldby A, Brandstrup B. Fluid therapy in the perioperative: setting a clinical review. J Intensive Care [Internet]. 2016 [citado 12 Feb 2018];4(27):[aprox. 12 p.]. Disponible en: https://jintensivecare.biomedcentral.com/track/pdf/10.1186/s40560-016-0154-3

  56. Futier E, Constantin JM, Petit A, Chanques G, Kwiatkowski F, Flamein R, et al. Conservative vs. restrictive individualized goal directed fluid replacement strategy in major abdominal surgery: A prospective randomized trial. Arch Surg [Internet]. 2010 [citado 12 Feb 2018];145(12):1193-200. Disponible en: https://jamanetwork.com/journals/jamasurgery/articlepdf/791071/soa05041_1193_1200.pdf




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