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The Ability of Stroke Volume Variation Measured by a Noninvasive Cardiac Output Monitor to Predict Fluid Responsiveness in Mechanically Ventilated Children

Pediatric Cardiology volume 35, pages 289–294 (2014)Cite this article

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.

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Acknowledgments

This study protocol was approved by the institutional review board of Gil Medical Center, Gachon University (IRB No. GIRBA 2738-2012).

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Affiliations

  1. Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, South Korea

    Ji Yeon Lee, Hong Soon Kim, Kyung Cheon Lee & Hyun Jeong Kwak

  2. Department of Anesthesiology and Pain Medicine, Anesthesiology and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea

    Ji Young Kim

  3. Department of Cardiothoracic Surgery, Gachon University Gil Medical Center, Incheon, South Korea

    Chang Hyu Choi

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  1. Ji Yeon Lee
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  2. Ji Young Kim
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  3. Chang Hyu Choi
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  4. Hong Soon Kim
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Correspondence to Hyun Jeong Kwak.

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Lee, J.Y., Kim, J.Y., Choi, C.H. et al. The Ability of Stroke Volume Variation Measured by a Noninvasive Cardiac Output Monitor to Predict Fluid Responsiveness in Mechanically Ventilated Children. Pediatr Cardiol 35, 289–294 (2014). https://doi.org/10.1007/s00246-013-0772-7

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  • DOI: https://doi.org/10.1007/s00246-013-0772-7

Keywords

  • Aortic blood flow velocity
  • Children
  • Fluid responsiveness
  • Noninvasive cardiac output monitor
  • Stroke volume variation