Mini Bolus for Fluid Challenge Responsiveness in the Emergency Department

What this Trial Is About

Researchers are investigating how a small fluid test, called a mini-bolus fluid challenge, can predict whether critically ill patients who are breathing on their own and experiencing unstable blood flow will benefit from receiving more fluids. This is important because giving fluids to patients who do not need them can cause harm, such as swelling or poor oxygen delivery. The study focuses on patients with acute circulatory failure, which means their blood pressure is low or they need medications to support their heart function, and signs of poor tissue blood flow. The study compares two methods to assess fluid responsiveness: giving a 50 ml mini-bolus of crystalloid fluid over 30 seconds and performing a passive leg raising (PLR) test, where the patient's legs are lifted while lying down to see if their heart output improves. Researchers measure heart function using special monitors that track cardiac output and stroke volume before and after these tests. The mini-bolus and PLR are done during the emergency care period to see which predicts fluid responsiveness better. Participants will have their heart rate, blood pressure, and cardiac output monitored at different times: before and after the mini-bolus, and before and after the PLR test. Patient details like age, sex, cause of circulatory failure, medications, and severity scores are also recorded. The main outcome is how well the continuous cardiac output monitor predicts fluid responsiveness three minutes after the fluid test. Researchers keep medication doses stable during measurements and watch for any changes in heart performance. The study occurs during acute care, with close monitoring to assess treatment response and safety.

Mini Bolus for Fluid Challenge Responsiveness in the Emergency Department