What is a fluid challenge?

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.