A Mini-Fluid Challenge to Predict Fluid Responsiveness in Swine

Area of Science:

• Veterinary Medicine
• Critical Care
• Hemodynamics

Background:

• Excessive fluid administration in intensive care can lead to adverse effects like pulmonary edema.
• Mini-fluid challenge (MFC) is used in human medicine to predict fluid responsiveness and guide therapy.
• The efficacy of MFC in veterinary medicine, specifically in pigs, requires investigation.

Purpose of the Study:

• To evaluate the efficacy of mini-fluid challenge (MFC) in predicting fluid responsiveness in anesthetized pigs.
• To determine if MFC can identify pigs that would benefit hemodynamically from fluid therapy.
• To assess the predictive accuracy of different fluid volumes and pulse pressure variation for fluid responsiveness in pigs.

Main Methods:

• Thirty-two anesthetized pigs under mechanical ventilation received sequential intravenous fluid boluses (2, 1, 1, 2 mL/kg) of Ringer lactate.
• Mean arterial pressure (MAP) increase was measured after cumulative fluid administration.
• Responders were defined as those with ≥10% MAP increase after 6 mL/kg total fluid; non-responders had <10% increase.

Main Results:

• Eleven out of 32 pigs were identified as responders.
• Responder status was accurately predicted by 3 mL/kg MFC (AUC = 0.98) and moderately predicted by 2 mL/kg MFC (AUC = 0.80).
• Pulse pressure variation also showed moderate predictive accuracy (AUC = 0.75).

Conclusions:

• Mini-fluid challenge is an effective tool for predicting fluid responsiveness in pigs.
• MFC can guide fluid therapy in pigs, optimizing circulatory dynamics and tissue perfusion.
• This approach helps avoid unnecessary fluid administration and associated risks in swine models.