Hemodynamics, fluids & transfusion
Attenuation of the plasma volume response to crystalloid fluid used for goal-directed fluid therapy
Authors' conclusion
Attenuation of the plasma volume response to bolus infusions of crystalloid fluid occurs. The second and third bolus might not increase cardiac preload enough to allow a correct diagnosis of fluid responsiveness. This problem is not shared by colloid fluid.
Study context
- Population
- Anaesthetized patients (volume kinetics of crystalloid fluid)
- Participants
- 103 anaesthetized patients
- Comparison
- Repeated bolus infusions of crystalloid vs colloid fluid
- Crystalloidn = 103
- Outcome
- Plasma volume response to repeated bolus infusions
Methodological detailsColloid (hydroxyethyl starch) parameters taken from the literature; boluses separated by a free interval of 5 min to allow hemodynamic assessment
- Colloid (hydroxyethyl starch) parameters taken from the literature; boluses separated by a free interval of 5 min to allow hemodynamic assessment
Main finding
As reported in the abstract
Plasma volume response to repeated bolus infusions (simulation)
Crystalloid: plasma volume increase by 2nd bolus, as % of 1st
51%
Crystalloid: plasma volume increase by 3rd bolus, as % of 1st
36%
Further findings
Preceding constant-rate crystalloid infusion (5 or 10 mL/kg/h over 60 min)
- Attenuation also occurred
Trendelenburg position (head down)
- Reduced the attenuation
Bleeding
- Increased plasma volume responses, but attenuation still occurred
Original publication
Attenuation of the plasma volume response to crystalloid fluid used for goal-directed fluid therapy. Ann Intensive Care. Published 19 June 2025. doi:10.
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