Consistency of data reporting in fluid responsiveness studies in the critically ill setting: the CODEFIRE consensus...

Area of Science:

• Critical Care Medicine
• Cardiovascular Physiology
• Clinical Research Methodology

Background:

• Standardized reporting of hemodynamic data is crucial for interpreting fluid responsiveness and fluid challenge (FC) studies in intensive care units (ICUs).
• Existing literature lacks consensus on essential data points for these investigations, potentially hindering comparability and reproducibility.

Purpose of the Study:

• To establish consensus recommendations for reporting hemodynamic data in ICU studies evaluating fluid responsiveness.
• To define standardized parameters for the use and assessment of fluid challenges (FC) in critical care research.

Main Methods:

• A European Society of Intensive Care Medicine (ESICM) panel of 18 international experts and a methodologist conducted a systematic literature review.
• A three-step Delphi process was employed to achieve consensus on key domains and reporting items, with defined agreement thresholds.

Main Results:

• Consensus was reached on 52 recommendations/suggestions across 5 domains: ICU admission, mechanical ventilation, reason for FC, pre- and post-FC hemodynamic data, and pre-FC infused drugs.
• Strong agreement was found on FC volume (4 ml/kg) and reference variable (cardiac output), but no consensus on echocardiography use.
• Weak agreement was noted on FC administration rate (within 10 min).

Conclusions:

• The study established 5 key domains and 52 recommendations for reporting hemodynamic data in ICU fluid responsiveness research.
• These recommendations aim to enhance the quality and consistency of research in this critical care area.
• The findings provide a framework for future studies on fluid management in critically ill patients.