MENU ▼
Read by QxMD icon Read
search
OPEN IN READ APP
COMPARATIVE STUDY
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Haemodynamic effects of cold versus warm fluid bolus in healthy volunteers: a randomised crossover trial

Olof Wall, Lars Ehrenberg, Eva Joelsson-Alm, Johan Mårtensson, Rinaldo Bellomo, Christer Svensén, Maria Cronhjort
Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine 2018, 20 (4): 277-284
30482135

OBJECTIVE: To test the hypothesis that changes in cardiac index and mean arterial pressure (MAP) during and after a fluid bolus (FB) are altered by fluid temperature.

DESIGN: Randomised, controlled, crossover trial.

SETTING: Research laboratory at Swedish teaching hospital.

PARTICIPANTS: Twenty-one healthy adult volunteers.

INTERVENTIONS: Subjects were randomly allocated to 500 mL of Ringer's acetate at room temperature (22°C; cold) or body temperature (38°C; warm).

MAIN OUTCOME MEASURES: For 2 hours after starting the FB, we measured cardiac index, MAP, systolic blood pressure, diastolic blood pressure and pulse rate (PR) continuously. We recorded temperature and O2 saturation every 5 minutes during infusion and every 15 minutes thereafter. In a second session, volunteers crossed over.

RESULTS: During the first 15 minutes, mean cardiac index increased more with warm FB (0.09 L/min/m2 [95% CI, 0.06-0.11] v 0.03 L/min/m2 [95% CI, 0.01-0.06]; P < 0.001). This effect was mediated by a significant difference in mean PR (+0.80 beats/min [95% CI, 0.47-1.13] v -1.33 beats/ min [95% CI, -1.66 to -1.01]; P < 0.010). In contrast, MAP increased more with cold FB (4.02 mmHg [95% CI, 3.63-4.41] v 0.60 mmHg [95% CI, 0.26-0.95]; P < 0.001). Cardiac index and MAP returned to baseline after a median of 45.3 min (interquartile range [IQR], 10.7-60.7 min) and 27.7 min (IQR, 5.3-105.0 min), respectively, after cold FB, and by 15.8 min (IQR, 3.8-64.3 min) and 22.7 min (IQR, 3.3-105.0 min), respectively, after warm FB.

CONCLUSION: Intravenous FB at body temperature leads to a greater increase in cardiac index compared with room temperature, while the reverse applies to MAP. These findings imply that in healthy volunteers, when a room temperature FB is given, the temperature of the fluid rather than its volume accounts for most of the MAP increase.

TRIAL REGISTRATION: EudraCT no. 2016-002548-18 and Clinicaltrials.gov NCT03209271.

Comments

You need to log in or sign up for an account to be able to comment.

No comments yet, be the first to post one!

Trending on Read

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
30482135
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"