Estimating mean circulatory filling pressure in clinical practice: a systematic review comparing three bedside methods in the critically ill

Wijnberge, Marije; Sindhunata, Daniko P.; Pinsky, Michael R.; Vlaar, Alexander P.; Ouweneel, Else; Jansen, Jos R.; Veelo, Denise P.; Geerts, Bart F.

doi:10.1186/s13613-018-0418-2

Annals of Intensive Care

Table 2 Mean circulatory filling pressure during different volumetric state

From: Estimating mean circulatory filling pressure in clinical practice: a systematic review comparing three bedside methods in the critically ill

Study	Method	N	Patient population	Baseline position	Baseline P_mcf	Hypervolemia (induced by fluid administration)	p value*	Amount of fluid administered to induce hypervolemia	Hypovolemia (induced by HUT)	p value^†
Maas et al. [21]	P_mcf hold	12	Cardiac surgery	Supine	18.7 (4.5)	29.1 (5.2)	0.001	500 mL colloid in 15–20 min	14.5 (3.0)	0.005
Keller et al. [23]	P_mcf hold	9	Cardiac surgery	Semirecumbent	19.7	26.9	< 0.05	500 mL colloid	–	–
					IQR 17.0–22.6	IQR 18.4–31.0
Maas et al. [22]	P_mcf hold	10	Cardiac surgery	Not described	18.7 (4.0)	26.4 (3.2)	< 0.001	500 mL colloid	–	–
Guerin et al. [28]	P_mcf hold	30	Shock	Semirecumbent	Responder: 25 (13)	32 (17)	< 0.01	500 mL saline in 10 min
					Non-responders: 24 (10)	28 (12)	< 0.01
Geerts et al. [43]	P_mcf arm	24	Cardiac surgery	Supine	Responders: 16.2 (6.3)	22.0 (7.6)	< 0.001	500 mL colloid	–	–
					Non-responders: 24.3 (8.2)	29.9 (9.1)	< 0.001
Aya et al. [41]	P_mcf arm	20	Cardiac surgery	Supine	22.4 (7.7)	–	–	–	–	–
Aya et al. [42]	P_mcf arm	80	Cardiac surgery	Supine	23.0	–	–	–	–	–
					Range: 17.3–29.8
Parkin et al. [49]	P_mcf analogue	10	CVVH	Not described	Target state = 15.9	–	–	CVVHD	–	–
Cecconi et al. [48]	P_mcf analogue	39	Heterogenous	Not described	Responders: 17.8 (5.1)	20.9 (5.1)	< 0.001	Mean 252 (8.9) mL	–	–
					Non-responders: 17.9 (5.1)	21.0 (4.9)	< 0.001	52.5% crystalloid
								37.6% colloid
								8.8% FFP & RBC
Gupta et al. [20]	P_mcf analogue	61	Cardiac surgery	Supine	Responders: 17 (3.7)	19 (4.3)	0.02	Mean 264 (16) mL	–	–
					Non-responders: 17 (3.6)	19 (4.1)	0.03	50% saline. Other 50%: mix of FFP, platelets, albumin, packed RBC, return of pump blood
Aya et al. [51]	P_mcf analogue	26	Heterogenous	Not described	Responders: 13.7 IQR: 10.9–16.9			250 mL crystalloid
					Non-responders: 16.7 IQR: 10.5–18.9
Maas et al. [16]	P_mcf hold	11	Cardiac surgery	Supine	19.7 (3.9)	28.3 (3.6)	< 0.001	500 mL colloid	16.2 (3.0)	0.001
	P_mcf arm				18.4 (3.7)	27.1 (4.0)	< 0.001		15.4 (3.1)	0.001
	P_mcf analogue				14.7 (2.7)	19.2 (1.1)	< 0.001		10.9 (2.0)	< 0.001
Maas et al. [30]	P_mcf arm	15	Cardiac surgery	Supine	21.0 (6.8)	27.7 (7.4)	< 0.001	500 mL colloid (10 steps of 50 mL)	–	–
	P_mcf hold^#

Data presented as mean with SD or median with interquartile range (IQR). P_mcf in mmHg. Hypovolemic state induced by head up tilt (HUT) to 30°. Responders = fluid responsiveness was defined by a 10% increase in CO
* p value, difference between baseline and hypervolemia induced by fluid administration
^†p value, difference between baseline and hypovolemic state

Back to article page