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The time course of fluid responsiveness
Ricardo Castro1,2, Eduardo Kattan1,2, Paulo Melo1,3
1Departamento de Medicina Intensiva. Facultad de Medicina. Pontificia Universidad Catolica de Chile, Chile.
Annals of Intensive Care
|April 6, 2026
Summary
Fluid responsiveness (FR) is dynamic in critically ill patients, not a stable state. Frequent reassessment of fluid responsiveness is vital for personalized fluid therapy and improved outcomes.
Area of Science:
- Critical Care Medicine
- Hemodynamics
- Physiology
Background:
- Fluid responsiveness (FR) is crucial for hemodynamic management in critically ill patients.
- Understanding FR's dynamic nature is essential for effective fluid therapy.
- Current management often overlooks the transient characteristics of FR.
Purpose of the Study:
- To review the temporal dynamics of fluid responsiveness.
- To identify factors influencing the duration and decay of FR.
- To emphasize the need for repeated FR assessments in clinical practice.
Main Methods:
- Literature review focusing on the time course of fluid responsiveness.
- Analysis of patient-specific factors and treatments affecting FR.
- Synthesis of evidence on dynamic hemodynamic monitoring.
Main Results:
- Fluid responsiveness is a dynamic continuum, not a static state.
- Factors like resuscitation stage, fluid infusion, and vasopressor use significantly alter FR.
- The hemodynamic response to fluids has a defined duration and decay pattern.
Conclusions:
- Frequent reassessment of fluid responsiveness is necessary.
- Individualizing fluid therapy based on dynamic FR is key.
- Integrating dynamic FR knowledge can optimize resuscitation protocols and patient outcomes.
Keywords:
Fluid responsiveness
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