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Impact of Intravenous Fluid Challenge Infusion Time on Macrocirculation and Endothelial Glycocalyx in Surgical and Critically Ill Patients

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F44555601%3A13450%2F18%3A43894528" target="_blank" >RIV/44555601:13450/18:43894528 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11140/18:10382643 RIV/00216208:11150/18:10382643 RIV/00179906:_____/18:10382643 RIV/00669806:_____/18:10382643

  • Result on the web

    <a href="https://www.hindawi.com/journals/bmri/2018/8925345/" target="_blank" >https://www.hindawi.com/journals/bmri/2018/8925345/</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1155/2018/8925345" target="_blank" >10.1155/2018/8925345</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Impact of Intravenous Fluid Challenge Infusion Time on Macrocirculation and Endothelial Glycocalyx in Surgical and Critically Ill Patients

  • Original language description

    (i) Purpose. The fluid challenge (FC) is a well-established test of preload reserve. Only limited data exist in regard to the FC efficacy based on infusion time. Slow administration may be associated with lack of effect based on fluid redistribution and external conditions changes. On the contrary, fast administration may lead to brisk fluid overload and damage to the endothelium and endothelial glycocalyx (EG). The aim of this trial was to compare the FC infusion time on its hemodynamic effects and EG. Methods. Prospective randomized single-center trial of fast (5-10 minutes) versus slow (20-30 minutes) administration of 500ml balanced crystalloid FC in spinal surgery (cohort OR) and septic shock (cohort SEP) patients. Hemodynamic response was assessed using standard monitoring and blood flow measurements; damage to EG was assessed using the perfused boundary region (PBR) via intravital microscopy monitoring in the sublingual region within relevant time points ranging up to 120 minutes. (iii) Results. Overall, 66 FCs in 50 surgical and 16 septic patients were assessed. Fluid administration was associated with increase of PBR in general (1.9 (1.8-2.1) vs. 2.0 (1.8-2.2); p= 0.008). These changes were transient in OR cohort whereas they were long-lasting in septic fluid responders. The rate of fluid responsiveness after fast versus slow administration was comparable in global population (15 (47%) vs. 17 (50%); p=0.801) as well as in both cohorts. (iv) Conclusions. Fluid challenge administration was associated with increased PBR (and presumable EG volume changes) which normalized within the next 60 minutes in surgical patients but remained impeded in septic fluid responders. The fluid responsiveness rate after fast and slow FC was comparable, but fast administration tended to induce higher, though transient, response in blood pressure.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30221 - Critical care medicine and Emergency medicine

Result continuities

  • Project

    <a href="/en/project/NV15-31881A" target="_blank" >NV15-31881A: Alterations of glycocalyx in critical illness and during major surgery and approaches for glycocalyx protection</a><br>

  • Continuities

    V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Others

  • Publication year

    2018

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    BioMed research international

  • ISSN

    2314-6133

  • e-ISSN

  • Volume of the periodical

    neuveden

  • Issue of the periodical within the volume

    2018

  • Country of publishing house

    GB - UNITED KINGDOM

  • Number of pages

    11

  • Pages from-to

    "nestrankovano"

  • UT code for WoS article

    000449781900001

  • EID of the result in the Scopus database

    2-s2.0-85058734953