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lunes, 18 de noviembre de 2019

Fluid Bolus on CV Collapse During RSI

R.E.B.E.L.EM - By Anand Swaminathan - November 11, 2019
"Authors Conclusions:
“Administration of an intravenous fluid bolus did not decrease the overall incidence of cardiovascular collapse during tracheal intubation of critically ill adults compared with no fluid bolus in this trial.”
Our Conclusions: 
In this mixed etiology, primarily ICU trial, initiation of a fluid bolus did not appear to decrease the risk of cardiovascular collapse peri-intubation. However, this data is not conclusive due to methodological issues.
Potential to Impact Current Practice: 
Our prior understanding of the physiology of intubation and peri-intubation decompensation tells us that universal administration of a fluid bolus is unlikely to benefit patients. This study does not change this understanding.
Bottom Line: 
It is unlikely that universal fluid bolus administration prior to induction of anesthesia for intubation would benefit patients. However, there is likely a group that will benefit. The administration of fluids peri-intubation should continue to be based upon the clinician’s assessment of the individual patient"