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Consistency of data reporting in fluid responsiveness studies in the critically ill setting: the CODEFIRE consensus from the Cardiovascular Dynamic section of the European Society of Intensive Care Medicine

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Abstract

Purpose

To provide consensus recommendations regarding hemodynamic data reporting in studies investigating fluid responsiveness and fluid challenge (FC) use in the intensive care unit (ICU).

Methods

The Executive Committee of the European Society of Intensive Care Medicine (ESICM) commissioned and supervised the project. A panel of 18 international experts and a methodologist identified main domains and items from a systematic literature, plus 2 ancillary domains. A three-step Delphi process based on an iterative approach was used to obtain the final consensus. In the Delphi 1 and 2, the items were selected with strong (≥ 80% of votes) or week agreement (70–80% of votes), while the Delphi 3 generated recommended (≥ 90% of votes) or suggested (80–90% of votes) items (RI and SI, respectively).

Results

We identified 5 main domains initially including 117 items and the consensus finally resulted in 52 recommendations or suggestions: 18 RIs and 2 SIs statements were obtained for the domain “ICU admission”, 11 RIs and 1 SI for the domain “mechanical ventilation”, 5 RIs for the domain “reason for giving a FC”, 8 RIs for the domain pre- and post-FC “hemodynamic data”, and 7 RIs for the domain “pre-FC infused drugs”. We had no consensus on the use of echocardiography, strong agreement regarding the volume (4 ml/kg) and the reference variable (cardiac output), while weak on administration rate (within 10 min) of FC in this setting.

Conclusion

This consensus found 5 main domains and provided 52 recommendations for data reporting in studies investigating fluid responsiveness in ICU patients.

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Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work has not been funded by an external source.

Author information

Author notes

  1. Antonio Messina and Michelle S. Chew share joint first authorship.

  2. Maurizio Cecconi and Xavier Monnet joint senior authorship.

Authors and Affiliations

  1. IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano (Milan), Italy

    Antonio Messina, Lorenzo Calabrò & Maurizio Cecconi

  2. Department of Biomedical Sciences, Humanitas University, via Levi Montalcin,i 4, Pieve Emanuele (Milan), Italy

    Antonio Messina & Maurizio Cecconi

  3. Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden

    Michelle S. Chew

  4. Anesthesia and Intensive Care Operative Unit, S. Martino Hospital, Belluno, Italy

    Daniele Poole

  5. Department of Intensive Care, CHIREC Hospitals, Université Libre de Bruxelles, Brussels, Belgium

    Daniel De Backer

  6. Department of Surgery, Dentistry, Gynecology and Paediatrics, University of Verona, Via Dell’artigliere 8, 37129, Verona, Italy

    Katia Donadello

  7. Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

    Glenn Hernandez

  8. Service de Médecine Intensive Réanimation Polyvalente, Robert Debré Hospital, University Hospitals of Reims, Unité HERVI « Hémostase et Remodelage Vasculaire Post-Ischémie » – EA 3801, University of Reims, Reims, France

    Olfa Hamzaoui

  9. Centre Hospitalier Universitaire L’Archet 1, Service de Médecine Intensive Réanimation, Nice, France

    Mathieu Jozwiak

  10. Equipe 2 CARRES, UR2CA Unité de Recherche Clinique Université Côte d’Azur, Université Côte d’Azur, Nice, France

    Mathieu Jozwiak

  11. DMU CORREVE, Inserm UMR S_999, FHU SEPSIS, Groupe de Recherche Clinique CARMAS, Université Paris-Saclay, AP-HP, Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France

    Christopher Lai, Jean-Louis Teboul & Xavier Monnet

  12. First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland

    Manu L. N. G. Malbrain

  13. Critical Care Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

    Jihad Mallat

  14. Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India

    Sheyla Nainan Myatra

  15. Department of Anaesthesia, Critical Care and Emergency Medicine, Nîmes University Hospital, Place du Professeur Debré, 30029, Nîmes, France

    Laurent Muller

  16. Department of Intensive Care, Fundación Valle del Lili - Universidad ICESI, Cali, Colombia

    Gustavo Ospina-Tascon

  17. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Michael R. Pinsky

  18. Intensive Care Unit, Calmette Hospital, University Hospital of Lille, 59000, Lille, France

    Sebastian Preau

  19. Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Bernd Saugel

  20. Hôpital universitaire Carémeau, University of Montpellier (MUSE), Nîmes, France

    Laurent Muller

Authors
  1. Antonio Messina
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  2. Michelle S. Chew
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  3. Daniele Poole
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  4. Lorenzo Calabrò
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  5. Daniel De Backer
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  6. Katia Donadello
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  7. Glenn Hernandez
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  8. Olfa Hamzaoui
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  9. Mathieu Jozwiak
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  10. Christopher Lai
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  11. Manu L. N. G. Malbrain
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  12. Jihad Mallat
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  13. Sheyla Nainan Myatra
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  14. Laurent Muller
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  15. Gustavo Ospina-Tascon
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  16. Michael R. Pinsky
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  17. Sebastian Preau
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  18. Bernd Saugel
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  19. Jean-Louis Teboul
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  20. Maurizio Cecconi
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  21. Xavier Monnet
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Contributions

AM: Chair and Content expert. MSC: Co-chair and Content expert. DP: Methods Chair. LC: involved in data search and extraction—non-voting member. DDB: Co-chair and Content expert. KD: Content expert. GH: Content expert. OH: Content expert. MJ: Content expert. CL: involved in data search and extraction—non-voting member. MLNGM: Content expert. JM: Content expert. SM: Content expert. LM: Content expert. GO-T: Content expert. MRP: Co-chair and Content expert. SP: Content expert. BS: Content expert. J-LT: Co-chair and Content expert. MC: Co-chair and Content expert. XM: Co-chair and Content expert.

Corresponding author

Correspondence to Antonio Messina.

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Competing interests for the present study: none declared. Disclosure of potential conflicts of interest unrelated to the present study: AM received travel expenses and registration for meetings, congresses, and courses and lecture fees from Vygon, Phlips, Edwards; MC is a consultant for Edwards Lifesciences (Directed Systems Consultancy); MSC received travel reimbursements and speaker fees from Edwards Lifesciences and from AOP Health; MLNGM is a member of the Medical Advisory Board of Pulsion Medical Systems (part of the Getinge Group), Serenno Medical, Potrero Medical, Sentinel Medical Technologies, and Baxter, and consults for B. Braun, Becton Dickinson, ConvaTec, Spiegelberg, Medtronic, and Holtech Medical. He holds stock options for Serenno Medical and Potrero Medical. He received speaker’s fees from PeerVoice. He is a co-founder and the President of the International Fluid Academy (IFA). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Edwards Lifesciences (Irvine, CA, USA). BS is a consultant for Philips North America (Cambridge, MA, USA) and has received honoraria for giving lectures from Philips Medizin Systeme Böblingen (Böblingen, Germany). BS has received institutional restricted research grants and honoraria for giving lectures from Baxter (Deerfield, IL, USA). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from GE Healthcare (Chicago, IL, USA). BS has received institutional restricted research grants and honoraria for giving lectures from CNS ystems Medizintechnik (Graz, Austria). BS is a consultant for Maquet Critical Care (Solna, Sweden). BS has received honoraria for giving lectures from Getinge (Gothenburg, Sweden). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Pulsion Medical Systems (Feldkirchen, Germany). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Vygon (Aachen, Germany). BS is a consultant for and has received institutional restricted research grants from Retia Medical (Valhalla, NY, USA). BS has received institutional restricted research grants from Osypka Medical (Berlin, Germany). BS was a consultant for and has received institutional restricted research grants from Tensys Medical (San Diego, CA, USA). BS is an Editor of the British Journal of Anaesthesia; OH received honoraria from Baxter for lectures; KD personally received honoraria for giving lectures from Bard, Bd, MSD and Biotest and she is a member of the Medical Advisory Board of Gylead and Viatris; XM is a member of the medical advisory board of Pulsion Medical Systems (Getinge), and has given lectures for Baxter; DDB received honoraria from Edwards Lifesciences and Philips for lectures; CL received honoraria Sedana Medical for lectures. LM received honoraria General Electric Ultrasound for lectures.

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Messina, A., Chew, M.S., Poole, D. et al. Consistency of data reporting in fluid responsiveness studies in the critically ill setting: the CODEFIRE consensus from the Cardiovascular Dynamic section of the European Society of Intensive Care Medicine. Intensive Care Med 50, 548–560 (2024). https://doi.org/10.1007/s00134-024-07344-4

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