Mini Fluid Challenge for Prediction of Fluid Responsiveness in Patients with Intra-Aortic Balloon Pump after Cardiac Surgery
Introduction: Patients with implanted Intra-Aortic Balloon Pump (IABP) after cardiac surgery present a unique challenge to intensivists in many terms including fluid management. One way to objectify fluid institution is to predict fluid responsiveness-whether cardiac output is to be increased after a fluid bolus-using a mini fluid challenge test. That elegant bedside test is simple and reduces fluid overload risk compared to classic fluid challenge.
Materials and methods: Patients with implanted IABP in the early period after open heart surgery were included in this study. A mini fluid challenge test was conducted. Cardiac output measurements were obtained before and after fluid bolus of 2 ml/kg body weight. Afterwards a fluid bolus of 4 ml/kg was administered and cardiac output was measured again.
Results: Mini fluid challenge showed significant predictive value for fluid responsiveness with an area under the ROC curve of 89.5% (95% CI (Confidence Level) 78%-100%). Best cut off value was 7.7% change in cardiac output (sensitivity 84.2%, specificity 81.8%).
Conclusion: IABP patients may benefit from a mini fluid challenge as an efficient predictor of fluid therapy response.