Evidence map›Paper›PMID 30987597›Full record

Observational studyBMC anesthesiology2019

Validity of mini-fluid challenge for predicting fluid responsiveness following liver transplantation.

Ahmed Mukhtar, Maha Awad, Mohamed Elayashy, Amr Hussein, Gihan Obayah, Akram El Adawy, Mai Ahmed, Hisham Abul Dahab, Ahmed Hasanin, Amr Elfouly and 3 more

Registry-linked trialOpen access · goldAbstract readObservational StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC anesthesiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03396159 (Validity of Mini Fluid Challenge to Assess Fluid Responsiveness Post Liver Transplantation), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

NCT03396159 nacompletednot on this map

Validity of Mini Fluid Challenge to Assess Fluid Responsiveness Post Liver Transplantation

TypeinterventionalSponsorKasr El Aini HospitalRan2018 to 2018Enrolled30ConditionsLiver TransplantationArmsmini fluid challenge
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. A Prospective Observational Study of Rational Fluid Therapy in Asian Intensive Care Units: Another Puzzle Piece in Fluid Therapy.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Ahmed MukhtarDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt. Ahmed.Mukhtar@kasralainy.edu.eg.ORCID 0000-0002-0504-274X
Maha AwadDepartment of Critical Care, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed ElayashyDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Amr HusseinDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Gihan ObayahDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Akram El AdawyDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mai AhmedDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Hisham Abul DahabDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed HasaninDepartment of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt.
Amr ElfoulyDepartment of Internal Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt.
Mostafa AbdoDepartment of Surgery, Ainshams University, Cairo, Egypt.
Amr AbdelaalDepartment of Surgery, Ainshams University, Cairo, Egypt.
Jean Louis TeboulMedical ICU, Bicêtre Hospital, Paris-South University, Paris, France.
Cairo University · EGAin Shams University · EGBicêtre Hospital · FRHelwan University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMini-fluid challenge is a well tested and effective tool to predict fluid responsiveness under various clinical conditions. However, mini-fluid challenge has never been tested in patients with end-stage liver disease. This study investigated whether infusion of 150 ml albumin 5% can predict fluid responsiveness in cirrhotic patients following liver transplant.

methodsFifty patients receiving living donor liver transplant were included in the analysis. Mini-fluid challenge composed of 150 ml of albumin 5% administered over 1 min in three consecutive 50-ml fluid boluses. An additional 350 ml was then infused at a constant rate over 15 min (for a total of 500 ml). Stroke volume (SV) was measured as the product of the subaortic velocity time integral (VTI) and left ventricular outflow tract (LVOT) area. Fluid responsiveness was defined as an increase in SV by ≥15% after the infusion.

resultsFifty patients were enrolled in the study. Fourteen patients were classified with Child A, 15 patients with Child B, and 21 patients with Child C cirrhosis. Thirty four patients were fluid responders and 16 patients were fluid non-responders. After 150 ml of albumin 5%, the SV increased significantly in our cohort. The area under receiver operating curve (AUROC) was 0.7 (95% confidence interval [CI] 0.5-0.8, P = 0.005). In subgroup analysis, the SV increased significantly after mini fluid challenge in the Child A group (P = 0.017) but not Child B or C groups (P = 0.3 and 0.29, respectively). The AUROC for mini-fluid challenge in the Child A group was 0.86 (95% confidence interval [CI] 0.6-0.9, P = 0.0004), while mini-fluid challenge failed to discriminate between responders and non-responders in Child B and C groups.

conclusionA mini-fluid challenge of 150 ml albumin 5% can predict fluid responsiveness in liver transplant patients with fair sensitivity and specifiicty. Subgroup analyis revealed that minifluid challenge can predict fluid responsiveness in patients with Child A cirrhosis but not patients with Child B or C cirrhosis.

trial registrationNCT03396159 . (Prospective registered). Initial registration date was 10/01/2018.

Indexed as

AdultEnd Stage Liver DiseaseFemaleFluid TherapyHemodynamicsHumansLiver TransplantationMaleMiddle AgedPredictive Value of TestsProspective StudiesSerum Albumin, HumanSerum Albumin, HumanFluid responsivenessLiver transplantationMinifluid challenge

Identifiers

PMID30987597
PMCPMC6463636
OpenAlexW2938948129

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.