Study: Only 59% of young adults undergoing surgery are fluid responsive

Reviewed by James Ives, M.Psych. (Editor)Oct 16 2018

Cheetah Medical, a Massachusetts-based leader in non-invasive fluid management devices, today announced study results leveraging Cheetah Medical technology were presented at the American Society of Anesthesiologists ANESTHESIOLOGY 2018 annual meeting in San Francisco, held from October 13-17. The data show that in a population of young adults presenting for surgery, over 40 percent of patients were not fluid responsive prior to and after inducing anesthesia.

The prospective trial of 22 young adult patients (ages 18-30) presenting for surgery was led by Andrew Stasic, M.D., associate professor of clinical anesthesia at the Indiana University School of Medicine. Measurements of cardiac output, stroke volume (SV) and fluid volume responsiveness were collected before and after the induction of anesthesia. Patients were determined to be fluid responsive if SV increased more than 10 percent via passive leg raise (PLR) as measured by Cheetah technology. Hemodynamic measurements were taken prior to anesthesia administration. The measurements were then repeated after obtaining a steady state level of anesthesia before the start of surgery.

"Most clinicians would expect that all young patients presenting for surgery would be fluid responsive," said Dr. Stasic. "The study is important because it shows that this presumption is not true. 41 percent of our patients were not fluid responsive and possibly at higher risk of fluid mis-management."

The data from performing PLRs in the patient population showed that prior to the induction of anesthesia, only 59 percent (13/22) were fluid responsive. This percentage remained constant following the induction of anesthesia. Forty-one percent were not fluid responsive or preload dependent. Patients who are non-preload dependent may be at higher risk for complications due to inappropriate fluid management.

"These results demonstrate that not all patients are fluid responsive, including those of a younger demographic," said Doug Hansell, M.D., M.P.H., chief physician executive at Cheetah Medical. "Accurately assessing fluid responsiveness with technology like Cheetah's continues to be a critical component of risk mitigation associated with improper fluid management even in young adults."