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Related Experiment Video

Updated: Jun 17, 2026

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava
06:59

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava

Published on: January 13, 2023

Functional intravascular volume deficit in patients before surgery.

M Bundgaard-Nielsen1, C C Jørgensen, N H Secher

  • 1Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. morten.bundgaard-nielsen@rh.regionh.dk

Acta Anaesthesiologica Scandinavica
|December 17, 2009
PubMed
Summary

Most anesthetized surgical patients have a fluid deficit. Individualized goal-directed fluid therapy is crucial, as 70% needed fluid, and 15% required a significant volume to maximize stroke volume (SV).

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Last Updated: Jun 17, 2026

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Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
04:48

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Published on: November 28, 2018

Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Fluid Management

Background:

  • Individualized goal-directed therapy using colloid infusion maximizes stroke volume (SV) in high-risk surgery.
  • The prevalence and volume of intravascular deficits in surgical patients remain largely unevaluated.
  • Assessing functional intravascular volume deficit is key for optimizing surgical outcomes.

Purpose of the Study:

  • To estimate the occurrence and volume of functional intravascular volume deficits in patients before major surgery.
  • To determine the proportion of patients requiring fluid to achieve maximal stroke volume.
  • To evaluate the volume of fluid needed for stroke volume optimization.

Main Methods:

  • Patients undergoing mastectomy, prostatectomy, or abdominal surgery received 200 ml colloid fluid challenges.
  • Stroke volume (SV) was monitored using esophageal Doppler.
  • Fluid challenges were repeated until a >=10% increment in SV was achieved, defining the deficit.

Main Results:

  • 70% of patients (42/60) required fluid to achieve maximal SV.
  • The median fluid volume required was 200 ml (range 200-600 ml).
  • 15% of patients (9/60) needed >=400 ml of fluid, indicating a clinically relevant deficit.

Conclusions:

  • A functional intravascular volume deficit is common in anesthetized surgical patients.
  • While often minor, the fluid deficit can be clinically significant in a subset of patients.
  • Individualized goal-directed fluid therapy is essential for optimizing patient outcomes.