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What is a fluid challenge?

Cecconi, Maurizio; Parsons, Anthony K; Rhodes, Andrew

Current Opinion in Critical Care: June 2011 - Volume 17 - Issue 3 - p 290–295
doi: 10.1097/MCC.0b013e32834699cd
Cardiopulmonary monitoring: Edited by Andy Rhodes

Purpose of review The fluid challenge is used in the fluid management of many sick patients. The principle behind the fluid challenge technique is that by giving a small amount of fluid in a short period of time, the clinician can assess whether the patient has a preload reserve that can be used to increase the stroke volume with further fluids. The key components of a fluid challenge are described.

Recent findings Dynamic predictors of fluid responsiveness are increasingly used in preference to the central venous and pulmonary artery occlusion pressure. The gold standard to monitor the response to a fluid challenge is using a continuous cardiac output monitoring. Fluid therapy guided by flow monitoring has been shown to reduce hospital stay and postoperative complications.

Summary A fluid challenge identifies and simultaneously treats volume depletion, whilst avoiding deleterious consequences of fluid overload through its small volume and targeted administration.

Department of Intensive Care Medicine, St George's Healthcare NHS Trust, London, UK

Correspondence to Dr Maurizio Cecconi, MD, Department of Intensive Care Medicine, St George's Healthcare NHS Trust, London SW17 0QT, UK Tel: +44 208 725 0884; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.