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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2017

Open Access 01-12-2017 | Review

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

Authors: Mohammed H. Elwan, Ashraf Roshdy, Eman M. Elsharkawy, Salah M. Eltahan, Timothy J. Coats

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2017

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Abstract

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.
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Metadata
Title
The haemodynamic dilemma in emergency care: Is fluid responsiveness the answer? A systematic review
Authors
Mohammed H. Elwan
Ashraf Roshdy
Eman M. Elsharkawy
Salah M. Eltahan
Timothy J. Coats
Publication date
01-12-2017
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-017-0370-4

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