Related Experiment Video
Updated: Nov 8, 2025
07:59
Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
Published on: July 28, 2018
11.4K
Assisted Fluid Management Software Guidance for Intraoperative Fluid Administration.
Anesthesiology
|April 26, 2021
Summary
Software-guided fluid management during noncardiac surgery improved stroke volume increases compared to clinician-initiated boluses. This automated approach shows promise for optimizing intraoperative fluid administration and patient outcomes.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Surgical Fluid Management
Background:
- Intravenous fluid administration during noncardiac surgery is highly variable, leading to potential complications from excessive or inadequate fluid delivery.
- Current goal-directed management strategies are often complex and difficult to implement in practice.
- The Acumen Assisted Fluid Management software was developed to simplify and guide optimal fluid administration.
Purpose of the Study:
- To evaluate the performance of the Acumen Assisted Fluid Management software in guiding intravenous fluid administration during noncardiac surgery.
- To compare the effectiveness of software-recommended fluid boluses versus clinician-initiated boluses in achieving desired stroke volume increases.
- To assess the potential of automated fluid responsiveness assessment in optimizing intraoperative fluid management.
Main Methods:
- A multicenter, prospective, single-arm cohort study involving 330 adult patients undergoing moderate- to high-risk noncardiac surgery.
- Clinicians selected fluid strategies targeting specific stroke volume (SV) increases (10%, 15%, or 20%) post-fluid bolus.
- Fluid management software prompted "test" or "recommended" boluses, with clinicians able to accept, decline, or initiate "user" boluses.
Main Results:
- Software-recommended boluses achieved desired SV increases in 66% of cases, significantly higher than the 30% reference rate.
- Clinician-initiated boluses resulted in desired SV increases in only 41% of instances (P < 0.0001).
- The mean SV increase was significantly greater with software-recommended boluses (14.2 ± 13.9%) compared to clinician-initiated boluses (8.3 ± 12.1%).
Conclusions:
- Fluid boluses recommended by the Acumen software were more effective in achieving desired stroke volume increases than those initiated by clinicians.
- The software demonstrated a higher success rate and greater absolute increase in stroke volume.
- Automated assessment of fluid responsiveness via this software may enhance intraoperative fluid management during noncardiac surgery.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
96
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
96
01:23Peripheral Artery Disease V: Postoperative Nursing Management
91
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
91
01:17Flow Sheet
2.3K
Flowsheets are valuable tools in nursing documentation. They enable healthcare professionals to efficiently record and monitor various patient assessments and measurements in a consolidated format.
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
2.3K
01:25Hemodialysis III: Nursing Management
361
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
361
01:22Aneurysm IV: Nursing Management
121
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
121
01:22Acute Kidney Injury VI: Nursing Management
162
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
162