fluid challenge


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fluid challenge

The rapid infusion of fluids (crystalloids such as normal saline, or colloids, such as albumin) to resuscitate blood pressure in a patient thought to be hypovolemic.

Patient care

In a typical child 20 mL/kg of normal saline is given intravenously (or intraosseously) over 30 min. The volume infused into an adult is usually 250–1000 mL. The lower volume is used if there are concerns that the patient may develop pulmonary edema. The patient's blood pressure, heart rate and rhythm, oxygenation, and respirations are closely monitored during and after the infusion for evidence of a positive response, e.g., a mean arterial pressure that rises above 70 mm Hg, or deterioration, e.g., increasing dyspnea, ventricular ectopy, or hypoxia. Patients who respond favorably to a fluid challenge are typically placed on a maintenance infusion of fluids to sustain them hemodynamically.

See also: challenge
References in periodicals archive ?
Dynamic parameters of fluid responsiveness, including PPV and SW, have been shown to be superior to traditional static parameters in predicting rise in stroke volume following a fluid challenge (6, 7).
This endogenous fluid challenge as a surrogate method for intravascular fluid infusion sufficiently increases the mean systemic pressure to result in an increase of venous return and subsequent SV increase (8).
Of the 42 patients, 19 (45%) responded to fluid challenge, whereas 23 (55%) did not.{Table 1}
The actual acPED [less than or equal to] 0 (p.d.u.) was found in 296 (61.7 %) of the mini fluid challenges defined as non-responders.
where [PD.sub.i] is the plasma dilution after the fluid challenge number i, Hb is the initial hemoglobin concentration obtained before the first fluid challenge, [Hb.sub.i] is the hemoglobin concentration obtained after the fluid challenge number i, and Hct is the initial hematocrit value obtained before the first fluid challenge (since noninvasive Hct is not available during the noninvasive determination of the PD, the initial Hct is derived by dividing the noninvasive initial Hb by 330, which is the mean value of the normal range for the mean cell hemoglobin concentration).
Marmaite, "Goal directed fluid therapy revised: indirect monitoring of interstitial fluid accumulation during mini fluid challenges with crystalloids", Open Conf Proc J.,vol.
Fluid challenge in non-responsive patients may also delay institution of effective treatment, such as inotropes and vasopressors.
Studies have demonstrated that the reliability of blood pressure as a surrogate of stroke volume was poor,[sup][19] but blood pressure remains the most widely used parameter to assess the response of fluid challenge.[sup][3] Lakhal et al.
Calculation of normalised acGAP is performed in each individual from a pool after the first mini fluid challenge
Treatment for septic shock was standardized,[sup][4] including vasopressors (norepinephrine with epinephrine as a rescue therapy) to MAP, in addition to repeated fluid challenges with crystalloids, natural albumin, and artificial colloids (hydroxyethyl starch solutions) to achieve a CVP of 8–12 mmHg, to maintain a MAP of at least 65 mmHg and to ensure that the urine output was at least 0.5 ml*kg [sup]−1*h [sup]−1.