• Antonio Messina, Chiara Palandri, Silvia De Rosa, Vinicio Danzi, Efrem Bonaldi, Claudia Montagnini, Sara Baino, Federico Villa, Francesca Sala, Paola Zito, Katerina Negri, Della CorteFrancescoFDepartment of Anesthesia and Intensive Care Medicine, Maggiore Della Carità University Hospital, Novara, Italy., Gianmaria Cammarota, Laura Saderi, Giovanni Sotgiu, Manuel Ignacio Monge García, and Maurizio Cecconi.
• IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy. antonio.messina@humanitas.it.
• J Clin Monit Comput. 2022 Aug 1; 36 (4): 1193-1203.

PurposeA number of studies performed in the operating room evaluated the hemodynamic effects of the fluid challenge (FC), solely considering the effect before and after the infusion. Few studies have investigated the pharmacodynamic effect of the FC on hemodynamic flow and pressure variables. We designed this trial aiming at describing the pharmacodynamic profile of two different FC infusion times, of a fixed dose of 4 ml kg-1.MethodsForty-nine elective neurosurgical patients received two consecutive FCs of 4 ml kg-1 of crystalloids in 10 (FC10) or 20 (FC20) minutes, in a random order. Fluid responsiveness was defined as stroke volume index increase ≥ 10%. We assessed the net area under the curve (AUC), the maximal percentage difference from baseline (dmax), time when the dmax was observed (tmax), change from baseline at 1-min (d1) and 5-min (d5) after FC end.ResultsAfter FC10 and FC20, 25 (51%) and 14 (29%) of 49 patients were classified as fluid responders (p = 0.001). With the exception of the AUCs of SAP and MAP, the AUCs of all the considered hemodynamic variables were comparable. The dmax and the tmax were overall comparable. In both groups, the hemodynamic effects on flow variables were dissipated within 5 min after FC end.ConclusionsThe infusion time of FC administration affects fluid responsiveness, being higher for FC10 as compared to FC20. The effect on flow variables of either FCs fades 5 min after the end of infusion.© 2021. The Author(s), under exclusive licence to Springer Nature B.V.

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