Journal of clinical monitoring and computing
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J Clin Monit Comput · Jan 2025
Decision support guided fluid challenges and stroke volume response during high-risk surgery: a post hoc analysis of a randomized controlled trial.
Intravenous fluid is administered during high-risk surgery to optimize stroke volume (SV). To assess ongoing need for fluids, the hemodynamic response to a fluid bolus is evaluated using a fluid challenge technique. The Acumen Assisted Fluid Management (AFM) system is a decision support tool designed to ease the application of fluid challenges and thus improve fluid administration during high-risk surgery. ⋯ The median rate of fluid responsiveness was greater in the AFM than in the control group (50 [44-71] % vs 33 [20-40] %, p<0.001). The mean increase in SV after fluid challenge was also higher in the AFM than in the control group (12 [9-16] % vs 6 [3-10] %, p<0.001). AFM-initiated fluid challenges were more often associated with the desired increase in SV than were clinician-initiated fluid challenges, and absolute SV increases were greater.