title: The ability of stroke volume variation measured by a noninvasive cardiac output monitor to predict fluid responsiveness in mechanically ventilated children.
abstract: Continuous noninvasive cardiac output monitoring (NICOM) is a clinically useful tool in the pediatric setting. This study compared the ability of stroke volume variation (SVV) measured by NICOM with that of respiratory variations in the velocity of aortic blood flow (△Vpeak) and central venous pressure (CVP) to predict of fluid responsiveness in mechanically ventilated children after ventricular septal defect repair. The study investigated 26 mechanically ventilated children after the completion of surgery. At 30 min after their arrival in an intensive care unit, a colloid solution of 10 ml/kg was administrated for volume expansion. Hemodynamic variables, including CVP, stroke volume, and △Vpeak in addition to cardiac output and SVV in NICOM were measured before and 10 min after volume expansion. The patients with a stroke volume increase of more than 15 % after volume expansion were defined as responders. The 26 patients in the study consisted of 13 responders and 13 nonresponders. Before volume expansion, △Vpeak and SVV were higher in the responders (both p values <0.001). The areas under the receiver operating characteristic curves of △Vpeak, SVV, and CVP were respectively 0.956 (95 % CI 0.885-1.00), 0.888 (95 % CI 0.764-1.00), and 0.331 (95 % CI 0.123-0.540). This study showed that SVV by NICOM and △Vpeak by echocardiography, but not CVP, reliably predicted fluid responsiveness during mechanical ventilation after ventricular septal defect repair in children.
authors: Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea.
authors: Ji Yeon
authors: JY
authors: Lee
authors: Ji Young
authors: JY
authors: Kim
authors: Chang Hyu
authors: CH
authors: Choi
authors: Hong Soon
authors: HS
authors: Kim
authors: Kyung Cheon
authors: KC
authors: Lee
authors: Hyun Jeong
authors: HJ
authors: Kwak
mesh_terms: D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000502:physiology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D012372:ROC Curve; D012121:Respiration, Artificial; D013318:Stroke Volume / Q000502:physiology*
references: Pediatr Cardiol. 2010 Nov;31(8):1166-70
references: 20703453
references: Br J Anaesth. 2012 Jan;108(1):108-15
references: 22113930
references: Pediatr Cardiol. 2011 Apr;32(4):469-72
references: 21318463
references: Eur J Anaesthesiol. 2013 Aug;30(8):501-8
references: 23549128
references: Crit Care. 2012 Nov 09;16(6):460
references: 23158055
references: Paediatr Anaesth. 2008 Dec;18(12):1170-7
references: 19076570
references: Br J Anaesth. 2011 Jun;106(6):856-64
references: 21525016
references: Intensive Care Med. 2007 Jul;33(7):1191-1194
references: 17458538
references: Acta Anaesthesiol Scand. 2008 Mar;52(3):374-80
references: 18205899
references: J Cardiothorac Vasc Anesth. 2006 Feb;20(1):26-30
references: 16458209
references: Anaesthesia. 2011 Jul;66(7):582-9
references: 21539529
references: Crit Care Med. 2009 Sep;37(9):2642-7
references: 19602972
references: Intensive Care Med. 2008 May;34(5):888-94
references: 18259726
references: Am J Physiol Heart Circ Physiol. 2007 Jul;293(1):H583-9
references: 17384132
references: J Clin Monit Comput. 2012 Jun;26(3):153-5
references: 22430745
references: Acta Anaesthesiol Scand. 2010 Feb;54(2):191-8
references: 19764908
references: Chest. 2008 Jul;134(1):172-8
references: 18628220
references: Radiology. 1982 Apr;143(1):29-36
references: 7063747
references: Neonatology. 2012;102(1):61-7
references: 22508150
references: Stat Med. 1997 Jul 15;16(13):1529-42
references: 9249923
references: Crit Care Med. 2011 Feb;39(2):294-9
references: 21057311