Dynamic variables to predict fluid responsiveness in young children
Background The evidence that dynamic variables predict fluid responsiveness in young children is limited by conflicting research results. Methods Sixty patients, 1–3 years of age, undergoing major neurosurgery, received 10 mL/kg of Ringer's solution over 10 min after anesthesia induction. Respi...
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| Veröffentlicht in: | Pediatrics international 2023-01, Vol.65 (1), p.e15477-n/a |
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| creator | Liu, Ya‐Fei Song, Lin‐Lin Ma, Wei Wang, Dong‐Xin |
| description | Background
The evidence that dynamic variables predict fluid responsiveness in young children is limited by conflicting research results.
Methods
Sixty patients, 1–3 years of age, undergoing major neurosurgery, received 10 mL/kg of Ringer's solution over 10 min after anesthesia induction. Respiratory variation in aortic blood flow peak velocity (∆Vpeak), plethysmographic variability index (PVI), FloTrac/Vigileo‐derived stroke volume variation (SVV), dynamic arterial elastance (Eadyn), and pulse pressure variation (PPV) were measured before and following fluid loading. An increase in the cardiac index (CI) of ≥10% following fluid loading identified fluid “responders.”
Results
Twenty‐six patients (43.3%) were fluid responders. Baseline ∆Vpeak was an excellent predictor of a CI increase following fluid loading with an area under the receiver operating characteristic curve (AUROC) of 0.982 (p |
| doi_str_mv | 10.1111/ped.15477 |
| format | Article |
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The evidence that dynamic variables predict fluid responsiveness in young children is limited by conflicting research results.
Methods
Sixty patients, 1–3 years of age, undergoing major neurosurgery, received 10 mL/kg of Ringer's solution over 10 min after anesthesia induction. Respiratory variation in aortic blood flow peak velocity (∆Vpeak), plethysmographic variability index (PVI), FloTrac/Vigileo‐derived stroke volume variation (SVV), dynamic arterial elastance (Eadyn), and pulse pressure variation (PPV) were measured before and following fluid loading. An increase in the cardiac index (CI) of ≥10% following fluid loading identified fluid “responders.”
Results
Twenty‐six patients (43.3%) were fluid responders. Baseline ∆Vpeak was an excellent predictor of a CI increase following fluid loading with an area under the receiver operating characteristic curve (AUROC) of 0.982 (p < 0.001). The PVI showed fair diagnostic accuracy for CI‐fluid responsiveness (AUROC 0.775, p < 0.001). Baseline ∆Vpeak and PVI cutoff values were 9.6% and 15%, respectively. PPV, SVV, and Eadyn were not predictors or were poor predictors for CI‐fluid responsiveness (AUROC 0.669, 0.653, and 0.533, respectively).
Conclusion
Volume‐based PVI and ∆Vpeak showed acceptable reliability for fluid responsiveness prediction in young children undergoing major neurosurgery, whereas pressure‐based SVV using FloTrac/Vigileo, Eadyn, and PPV did not.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/ped.15477</identifier><identifier>PMID: 36652421</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Anesthesia ; Aorta ; Arteries ; Blood flow ; Blood Pressure - physiology ; Child ; Child, Preschool ; Children ; fluid responsiveness ; Hemodynamics ; Humans ; Neurosurgery ; Pediatrics ; plethysmographic variability index ; Reproducibility of Results ; ROC Curve ; Stroke Volume - physiology ; stroke volume variation ; Variation</subject><ispartof>Pediatrics international, 2023-01, Vol.65 (1), p.e15477-n/a</ispartof><rights>2023 Japan Pediatric Society.</rights><rights>2023 Japan Pediatric Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3777-9eb1789615a72ebe091d49975a4170af916713dd53c1ed2bb925c611f42e2d213</citedby><cites>FETCH-LOGICAL-c3777-9eb1789615a72ebe091d49975a4170af916713dd53c1ed2bb925c611f42e2d213</cites><orcidid>0000-0002-1805-6868</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fped.15477$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fped.15477$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36652421$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Ya‐Fei</creatorcontrib><creatorcontrib>Song, Lin‐Lin</creatorcontrib><creatorcontrib>Ma, Wei</creatorcontrib><creatorcontrib>Wang, Dong‐Xin</creatorcontrib><title>Dynamic variables to predict fluid responsiveness in young children</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Background
The evidence that dynamic variables predict fluid responsiveness in young children is limited by conflicting research results.
Methods
Sixty patients, 1–3 years of age, undergoing major neurosurgery, received 10 mL/kg of Ringer's solution over 10 min after anesthesia induction. Respiratory variation in aortic blood flow peak velocity (∆Vpeak), plethysmographic variability index (PVI), FloTrac/Vigileo‐derived stroke volume variation (SVV), dynamic arterial elastance (Eadyn), and pulse pressure variation (PPV) were measured before and following fluid loading. An increase in the cardiac index (CI) of ≥10% following fluid loading identified fluid “responders.”
Results
Twenty‐six patients (43.3%) were fluid responders. Baseline ∆Vpeak was an excellent predictor of a CI increase following fluid loading with an area under the receiver operating characteristic curve (AUROC) of 0.982 (p < 0.001). The PVI showed fair diagnostic accuracy for CI‐fluid responsiveness (AUROC 0.775, p < 0.001). Baseline ∆Vpeak and PVI cutoff values were 9.6% and 15%, respectively. PPV, SVV, and Eadyn were not predictors or were poor predictors for CI‐fluid responsiveness (AUROC 0.669, 0.653, and 0.533, respectively).
Conclusion
Volume‐based PVI and ∆Vpeak showed acceptable reliability for fluid responsiveness prediction in young children undergoing major neurosurgery, whereas pressure‐based SVV using FloTrac/Vigileo, Eadyn, and PPV did not.</description><subject>Anesthesia</subject><subject>Aorta</subject><subject>Arteries</subject><subject>Blood flow</subject><subject>Blood Pressure - physiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>fluid responsiveness</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Neurosurgery</subject><subject>Pediatrics</subject><subject>plethysmographic variability index</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>Stroke Volume - physiology</subject><subject>stroke volume variation</subject><subject>Variation</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM9LwzAUgIMoOqcH_wEpeNFDt7w0TZqjzJ8w0IOCt5A2r5rRtTVZJ_vvjU4vgrm88Pj4eHyEnACdQHzTHu0Eci7lDhkB5yxllL7sxn_GirSgQh6QwxAWlNJCFnyfHGRC5IwzGJHZ1aY1S1cla-OdKRsMyapLeo_WVaukbgZnE4-h79rg1thiCIlrk003tK9J9eYa67E9Inu1aQIe_8wxeb65fprdpfOH2_vZ5TytMillqrAEWSgBuZEMS6QKLFdK5oaDpKZWICRk1uZZBWhZWSqWVwKg5gyZZZCNyfnW2_vufcCw0ksXKmwa02I3BM2kEJIBBR7Rsz_ooht8G6_TTFHBpGI0j9TFlqp8F4LHWvfeLY3faKD6q6yOZfV32cie_hiHchm3v-RvyghMt8CHa3Dzv0k_Xl9tlZ_fZ4DD</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Liu, Ya‐Fei</creator><creator>Song, Lin‐Lin</creator><creator>Ma, Wei</creator><creator>Wang, Dong‐Xin</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1805-6868</orcidid></search><sort><creationdate>202301</creationdate><title>Dynamic variables to predict fluid responsiveness in young children</title><author>Liu, Ya‐Fei ; Song, Lin‐Lin ; Ma, Wei ; Wang, Dong‐Xin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3777-9eb1789615a72ebe091d49975a4170af916713dd53c1ed2bb925c611f42e2d213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anesthesia</topic><topic>Aorta</topic><topic>Arteries</topic><topic>Blood flow</topic><topic>Blood Pressure - physiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>fluid responsiveness</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Neurosurgery</topic><topic>Pediatrics</topic><topic>plethysmographic variability index</topic><topic>Reproducibility of Results</topic><topic>ROC Curve</topic><topic>Stroke Volume - physiology</topic><topic>stroke volume variation</topic><topic>Variation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Ya‐Fei</creatorcontrib><creatorcontrib>Song, Lin‐Lin</creatorcontrib><creatorcontrib>Ma, Wei</creatorcontrib><creatorcontrib>Wang, Dong‐Xin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Ya‐Fei</au><au>Song, Lin‐Lin</au><au>Ma, Wei</au><au>Wang, Dong‐Xin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dynamic variables to predict fluid responsiveness in young children</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2023-01</date><risdate>2023</risdate><volume>65</volume><issue>1</issue><spage>e15477</spage><epage>n/a</epage><pages>e15477-n/a</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Background
The evidence that dynamic variables predict fluid responsiveness in young children is limited by conflicting research results.
Methods
Sixty patients, 1–3 years of age, undergoing major neurosurgery, received 10 mL/kg of Ringer's solution over 10 min after anesthesia induction. Respiratory variation in aortic blood flow peak velocity (∆Vpeak), plethysmographic variability index (PVI), FloTrac/Vigileo‐derived stroke volume variation (SVV), dynamic arterial elastance (Eadyn), and pulse pressure variation (PPV) were measured before and following fluid loading. An increase in the cardiac index (CI) of ≥10% following fluid loading identified fluid “responders.”
Results
Twenty‐six patients (43.3%) were fluid responders. Baseline ∆Vpeak was an excellent predictor of a CI increase following fluid loading with an area under the receiver operating characteristic curve (AUROC) of 0.982 (p < 0.001). The PVI showed fair diagnostic accuracy for CI‐fluid responsiveness (AUROC 0.775, p < 0.001). Baseline ∆Vpeak and PVI cutoff values were 9.6% and 15%, respectively. PPV, SVV, and Eadyn were not predictors or were poor predictors for CI‐fluid responsiveness (AUROC 0.669, 0.653, and 0.533, respectively).
Conclusion
Volume‐based PVI and ∆Vpeak showed acceptable reliability for fluid responsiveness prediction in young children undergoing major neurosurgery, whereas pressure‐based SVV using FloTrac/Vigileo, Eadyn, and PPV did not.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>36652421</pmid><doi>10.1111/ped.15477</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-1805-6868</orcidid></addata></record> |
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| source | MEDLINE; Wiley Journals |
| subjects | Anesthesia Aorta Arteries Blood flow Blood Pressure - physiology Child Child, Preschool Children fluid responsiveness Hemodynamics Humans Neurosurgery Pediatrics plethysmographic variability index Reproducibility of Results ROC Curve Stroke Volume - physiology stroke volume variation Variation |
| title | Dynamic variables to predict fluid responsiveness in young children |
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