Assisted Fluid Management Software Guidance for Intraoperative Fluid Administration

Background Excessive or inadequate fluid administration causes complications, but despite this, during noncardiac surgery is highly variable. Goal-directed management helps optimize the amount and timing of administration; however, implementation difficult because algorithms are complex. The authors therefore tested performance Acumen Assisted Fluid Management software (Edwards Lifesciences, USA), which designed to guide optimal intravenous surgery. Methods In this multicenter, prospective, single-arm cohort evaluation, enrolled 330 adults scheduled for moderate- high-risk that required arterial catheter insertion mechanical ventilation. Clinicians chose a strategy based on desired 10%, 15%, 20% increase in stroke volume (SV) response bolus. Dedicated prompted “test” “recommended” boluses, clinicians were free initiate “user” bolus 100 500 ml crystalloid colloid. accept decline prompts. primarily compared fraction software-recommended boluses produced suitable increases SV 30% reference rate. On an exploratory basis, we responses clinician-initiated boluses. Results Four hundred twenty-four 479 (89%) 508 592 (86%) analyzed per protocol. Of those, 66% (95% CI, 62 70%) delivered recommended by resulted SV, with rate, whereas only 41% 38 44%) did (P < 0.0001). mean ± SD after was 14.2 13.9% versus 8.3 12.1% 0.0001) those initiated clinicians. Conclusions more often, greater absolute increase, than Automated assessment responsiveness may help intraoperative Editor’s Perspective What We Already Know about This Topic Article Tells Us That Is New