Back to Contents

Fluid Challenge Algorithm Use when there is suspected reduced circulatory volume
for Critical Care Patients (eg hypotension, tachycardia, oliguria, positive straight leg raise response)

Able to obtain CVP Give 200 ml

Start reading or SV via No Fluid Challenge Signs of Clinical Improvement? Yes
Doppler?
Wait 5 minutes
Yes No

Stop – Reassess
in 30 mins
Consider CVP
Measure
catheter OR Seek medical advice
Baseline SV / CVP
Oesphageal Doppler

Give 200 ml Give 200 ml Give 200 ml

Fluid Challenge Fluid Challenge Fluid Challenge

Wait 5 minutes Wait 5 minutes Wait 5 minutes

Yes Yes

SV increase > 10% (Doppler) SV increase > 10% (Doppler) SV increase > 10% (Doppler)
OR OR OR
CVP Increase < 3 cmsH2O? CVP Increase < 3 cmsH2O? CVP Increase < 3 cmsH2O?

No

Yes
No Signs of Clinical Improvement? No

Stop – Reassess
Yes No Seek medical advice
! in 30 mins
Rapid
fluid loss
eg Haemorrhage Consider other forms of circulatory
may result in no response Steve Batson, Sheila Adam, May 2006 support and / or PA catheter