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The haemodynamic dilemma in emergency care: Is fluid responsiveness the answer? A systematic review

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journal contribution
posted on 2017-04-03, 14:51 authored by Mohammed H. Elwan, Ashraf Roshdy, Eman M. Elsharkawy, Salah M. Eltahan, Timothy J. Coats
BACKGROUND: Fluid therapy is a common and crucial treatment in the emergency department (ED). While fluid responsiveness seems to be a promising method to titrate fluid therapy, the evidence for its value in ED is unclear. We aim to synthesise the existing literature investigating fluid responsiveness in ED. METHODS: MEDLINE, Embase and the Cochrane library were searched for relevant peer-reviewed studies published from 1946 to present. RESULTS: A total of 249 publications were retrieved of which 22 studies underwent full-text review and eight relevant studies were identified. Only 3 studies addressed clinical outcomes - including 2 randomised controlled trials and one feasibility study. Five articles evaluated the diagnostic accuracy of fluid responsiveness techniques in ED. Due to marked heterogeneity, it was not possible to combine results in a meta-analysis. CONCLUSION: High quality, adequately powered outcome studies are still lacking, so the place of fluid responsiveness in ED remains undefined. Future studies should have standardisation of patient groups, the target response and the underpinning theoretic concept of fluid responsiveness. The value of a fluid responsiveness based fluid resuscitation protocol needs to be established in a clinical trial.

History

Citation

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2017, 25:25

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

  • VoR (Version of Record)

Published in

Scandinavian Journal of Trauma

Publisher

BioMed Central

eissn

1757-7241

Acceptance date

2017-02-23

Copyright date

2017

Available date

2017-04-03

Publisher version

http://sjtrem.biomedcentral.com/articles/10.1186/s13049-017-0370-4

Language

en

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