ArticleAnnals of intensive care2026
Revisiting the fluid challenge and stroke volume optimisation after induction of general anaesthesia.
Article in Annals of intensive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: To be clinically useful in goal-directed fluid therapy, a fluid challenge (FC) must achieve a large enough blood volume change (ΔBV) to materially change ventricular preload and stroke volume (ΔSV). The same % change in BV for all the subsequent FCs must also be achieved. We explored under what circumstances these prerequisites can be met by referring to data from a clinical trial where 111 patients underwent three successive intravenous FCs using crystalloid (Ringer´s lactate) or colloid (hydroxyethyl starch), involving a total of 9 mL/kg of fluid, just after induction of general anaesthesia. Results: The three FC using crystalloid fluid increased SV by 2.5% while the colloid increased the SV by 29.2% (medians, Conclusion: Differences in effectiveness between crystalloid and colloid fluid when providing repeated FCs increase the risk of false negative indications of fluid non-responsiveness when crystalloid is used.
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