Relationship between global end-diastolic volume and cardiac output in critically ill infants and children.
OBJECTIVE
The objective of this study was to investigate possible correlations between the preload index global end-diastolic volume (GEDV) and the indexes of cardiac function, cardiac index, and stroke volume index in critically ill pediatric patients. The aim was to evaluate whether GEDV may help in the decision-making process concerning volume loading.


METHODS
Prospective clinical study.


METHODS
Pediatric intensive care unit of the Bambino Gesù Children's Research Hospital.


METHODS
Seventy patients, 40 male and 30 female, mean age 62 +/- 41 months (range 5-156 months), divided into six groups: group A, hemorrhagic shock, ten cases; group B, head injury, 21 cases; group C, septic shock, ten cases; group D, encephalitis, ten cases; group E, respiratory failure, nine cases; group F, cardiogenic shock, ten cases.


METHODS
All patients received volumetric hemodynamic monitoring following initial resuscitation and every 4 hrs thereafter or whenever a hemodynamic deterioration was suspected. During the cumulative in-hospital stay, a total 1,184 sets of measurements were done.


RESULTS
Findings are consistent with a statistically significant linear correlation of GEDV with cardiac index and stroke volume index in hemorrhagic shock (group A) (R2 = .647, p < .0001; R2 = .738, p < .0001) and cardiogenic shock (group F) (R2 = .645, p < .0001; R2 = .841, p < .0001).


CONCLUSIONS
GEDV may potentially be a useful guide to treatment in preload-dependent conditions, such as hemorrhagic and cardiogenic shock. In the other groups where there is little relationship between preload and cardiac function indexes, the influence of non-preload-dependent mechanisms on cardiac output is certainly more significant.
Cecchetti
Corrado
C
Terapia Intensiva Pediatrica, Dipartimento di Emergenza ed Accettazione, IRCS Bambino Gesù, Piazzale S Onofrio 5, Roma, Italia.
Lubrano
Riccardo
R
Cristaldi
Sebastian
S
Stoppa
Francesca
F
Barbieri
Maria Antonietta
MA
Elli
Marco
M
Masciangelo
Raffaele
R
Perrotta
Daniela
D
Travasso
Elisabetta
E
Raggi
Claudia
C
Marano
Marco
M
Pirozzi
Nicola
N
D000293:Adolescent; D002302:Cardiac Output; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D013318:Stroke Volume