ArticleIntensive care medicine2012
Can changes in arterial pressure be used to detect changes in cardiac index during fluid challenge in patients with septic shock?
Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 7 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
71 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Fluid challenge in critically ill patients receiving haemodynamic monitoring: a systematic review and comparison of two decades.Critical care (London, England) · 2022Pooled it
- Impact of hemodynamic goal-directed resuscitation on mortality in adult critically ill patients: a systematic review and meta-analysis.Journal of clinical monitoring and computing · 2018Pooled it
- What is the impact of the fluid challenge technique on diagnosis of fluid responsiveness? A systematic review and meta-analysis.Critical care (London, England) · 2017Pooled it
- Passive leg raising for predicting fluid responsiveness: a systematic review and meta-analysis.Intensive care medicine · 2016Pooled it
- Intravascular volume therapy in adults: Guidelines from the Association of the Scientific Medical Societies in Germany.European journal of anaesthesiology · 2016Guideline
- Physiological changes after fluid bolus therapy in sepsis: a systematic review of contemporary data.Critical care (London, England) · 2014Pooled it
- Do ScvOPhysiological reports · 2021Trial
- Preoperative carbohydrate loading and intraoperative goal-directed fluid therapy for elderly patients undergoing open gastrointestinal surgery: a prospective randomized controlled trial.BMC anesthesiology · 2021Trial
- Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study.Critical care (London, England) · 2013Trial
- Ultrasound of the inferior vena cava for fluid therapy decisions: Strengths, limitations, and an integrated approach.The Journal of international medical research · 2026Review
- Fluid challenge and left ventricular myocardial performance index assessed by transthoracic echocardiography with tissue Doppler imaging in critically ill patients with regular rhythm.Frontiers in medicine · 2026Article
- Applied physiology at the bedside: using invasive blood pressure as a true monitoring tool.Annals of intensive care · 2025Review
- Why do we use transpulmonary thermodilution and pulmonary artery catheter in severe shock patients?Annals of intensive care · 2025Article
- The Accuracy of the Passive Leg Raising Test Using the Perfusion Index to Identify Preload Responsiveness-A Single Center Study in a Resource-Limited Setting.Diagnostics (Basel, Switzerland) · 2025Article
- The Indian Society of Critical Care Medicine Position Statement on the Management of Sepsis in Resource-limited Settings.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Accuracy of Respiratory Variation in Inferior Vena Cava Diameter to Predict Fluid Responsiveness in Children Under Mechanical Ventilation.Pediatric cardiology · 2024Article
- Article
- Association between delayed invasive blood pressure monitoring and all-cause mortality in intensive care unit patients with sepsis: a retrospective cohort study.Frontiers in medicine · 2024Article
- How I personalize fluid therapy in septic shock?Critical care (London, England) · 2023Review
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeResponse to fluid challenge is often defined as an increase in cardiac index (CI) of more than 10-15%. However, in clinical practice CI values are often not available. We evaluated whether changes in mean arterial pressure (MAP) correlate with changes in CI after fluid challenge in patients with septic shock.
methodsThis was an observational study in which we reviewed prospectively collected data from 51 septic shock patients in whom complete hemodynamic measurements had been obtained before and after a fluid challenge with 1,000 ml crystalloid (Hartman's solution) or 500 ml colloid (hydroxyethyl starch 6%). CI was measured using thermodilution. Patients were divided into two groups (responders and non-responders) according to their change in CI (responders: %CI >10%) after the fluid challenge. Statistical analysis was performed using a two-way analysis of variance test followed by a Student's t test with adjustment for multiple comparisons. Pearson's correlation and receiver operating characteristic curve analysis were also used.
resultsMean patient age was 67 ± 17 years and mean Sequential Organ Failure Assessment (SOFA) upon admittance to the intensive care unit was 10 ± 3. In the 25 responders, MAP increased from 69 ± 9 to 77 ± 9 mmHg, pulse pressure (PP) increased from 59 ± 15 to 67 ± 16, and CI increased from 2.8 ± 0.8 to 3.4 ± 0.9 L/min/m(2) (all p < 0.001). There were no significant correlations between the changes in MAP, PP, and CI.
conclusionsChanges in MAP do not reliably track changes in CI after fluid challenge in patients with septic shock and, consequently, should be interpreted carefully when evaluating the response to fluid challenge in such patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.