Hemodynamics, fluids & transfusion
Effect of manual decongestive therapy on cardiac preload in critically ill patients: a randomized controlled trial
Authors' conclusion
MDT increases cardiac preload and helps to reduce interstitial fluid overload and edema in critically ill patients.
Study context
- Population
- Critically ill patients requiring advanced hemodynamic monitoring with thermodilution-calibrated pulse contour analysis
- Participants
- 34 patients
- Comparison
- Manual decongestive therapy (MDT) followed by elastic bandaging for 24 h vs standard care
- Primary endpoint
- Δ Global end-diastolic volume index (GEDI) as a marker of cardiac preload
- Follow-up
- 15, 30, 60 min and 24 h after MDT
Methodological detailsprospective
- Prospective
Primary result
As reported in the abstract
Δ GEDI
Significant increase in Δ GEDI with MDT vs control at 15 min
median 48 (IQR 82) to median −19 (IQR 39)
Significant increase in Δ GEDI with MDT vs control at 60 min
median 75 (IQR 106.5) to median −11 (IQR80)
Significant increase in Δ GEDI with MDT vs control at 24 h
median 107 (IQR 153) to median −16 (IQR 114)
Further findings
Ankle and wrist circumference (markers of local interstitial edema) · 24 h
- Standard care: ankle circumference increased significantly
- median 23.5 (IQR 5) cm to median 24 (IQR 6) cm, p < 0.0001
- Standard care: wrist circumference increased significantly
- median 18 (IQR 2) cm to median 19 (IQR 2) cm, p < 0.0001
- MDT: ankle circumference reduced significantly
- median 24.5 (IQR 5) cm to median 24 (IQR 4.5) cm, p < 0.0001
- MDT: wrist circumference reduced significantly
- median 20 (IQR 3.8) cm to median 18 (IQR 3.5) cm, p < 0.0001
Original publication
Effect of manual decongestive therapy on cardiac preload in critically ill patients: a randomized controlled trial. Ann Intensive Care. Published 24 March 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →