Does respiratory variation of inferior vena cava diameter predict fluid responsiveness in spontaneously ventilating children with sepsis

Long, Elliot; Duke, Trevor; Oakley, Ed; O’Brien, Adam; Sheridan, B.; Babl, Franz E

doi:10.1111/1742-6723.12948

Cited by 27 publications

(32 citation statements)

References 51 publications

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“…23 However, in a study performed in septic pediatric patients, the ability of the CVCCI to discriminate between responders and nonresponders was poor, with an area under the ROC curve of 0.38 (95% CI, 0.23 to 0.55). 24 The differences with our study could be related to the different species and ages studied, as well as the underlying illnesses. Unlike the quoted study, 24 our study included a heterogeneous population with only few septic patients.…”

Section: Discussioncontrasting

confidence: 63%

“…In patients undergoing mechanical ventilation, the pooled sensitivity and specificity were 0.79 (95% CI, 0.67 to 0.86) and 0.70 (95% CI, 0.63 to 0.76), respectively 23 . However, in a study performed in septic pediatric patients, the ability of the CVCCI to discriminate between responders and nonresponders was poor, with an area under the ROC curve of 0.38 (95% CI, 0.23 to 0.55) 24 . The differences with our study could be related to the different species and ages studied, as well as the underlying illnesses.…”

Section: Discussionmentioning

confidence: 98%

“…The differences with our study could be related to the different species and ages studied, as well as the underlying illnesses. Unlike the quoted study, 24 our study included a heterogeneous population with only few septic patients. The haemodynamic response of septic patients to fluid challenges might differ from that observed in hypovolemic patients 25 .…”

Section: Discussionmentioning

confidence: 99%

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Caudal vena cava collapsibility index as a tool to predict fluid responsiveness in dogs

Donati¹,

Guevara²,

Ardiles

et al. 2020

J Vet Emergen Crit Care

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Caudal vena cava collapsibility index as a tool to predict fluid responsiveness in dogs

Donati¹,

Guevara²,

Ardiles

et al. 2020

J Vet Emergen Crit Care

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“…Variations in diameters of the SCV and IVC with respiration must be interpreted in the clinical context to make treatment decisions. 3,19,29,30…”

Section: Resultsmentioning

confidence: 99%

<p>Comparison of Respiratory Variations of Subclavian Vein and Inferior Vena Cava in Hospitalized Patients with Kidney Disease</p>

Kaptein¹,

Cantillep²,

Kaptein³

et al. 2020

IJNRD

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Background Accurate assessment of relative intravascular volume is critical for appropriate volume management of patients with kidney disease. Respiratory variations of inferior vena cava (IVC) diameter have been used and may correlate with those of subclavian vein (SCV) by bedside ultrasound. The purpose of this study was to assess the relationship between SCV and IVC respiratory variations by bedside ultrasound in a large group of hospitalized patients with acute and/or chronic kidney disease. Methods We compared 160 paired SCV and IVC bedside ultrasound studies from 102 semi-recumbent hospitalized adult patients with kidney disease. Patient encounters in which the SCV or IVC could not be clearly visualized were excluded. Collapsibility index=(Dmax–Dmin)/Dmax*100%; D=venous diameter. Results Relationships between SCV collapsibility index and IVC collapsibility index were not different for longitudinal and transverse views of the SCV. Correlation of SCV collapsibility index with IVC collapsibility index was 0.75 for mechanical ventilation (n=65, P<0.0001) and 0.67 for spontaneous breathing (n=95, P<0.0001). IVC collapsibility index cut-offs <20% for hypervolemia and >50% for hypovolemia corresponded to SCV collapsibility index cut-offs of <22% and >39%, respectively, for both mechanical ventilation and spontaneous breathing encounters. Using these cut-offs for SCV collapsibilities, assessment as hypervolemia versus not-hypervolemia had maximal sensitivity and specificity for predicting respective IVC collapsibility cut-offs of 88% for mechanical ventilation and 74% for spontaneous breathing, and assessment as hypovolemia versus not-hypovolemia had maximal sensitivity and specificity of 91% and 70%, respectively. Concordance, defined as agreement between assessment using SCV CI and assessment using IVC CI, was 85% for mechanical ventilation and 72% for spontaneous breathing when differentiating hypervolemia versus not-hypervolemia and was 89% and 71% respectively when differentiating hypovolemia versus not-hypovolemia. Conclusion Assessment using SCV collapsibility index in the semi-recumbent position has a reasonable concordance with assessment using IVC collapsibility index for both spontaneous breathing and mechanical ventilation, in a wide range of hospitalized patients with concurrent kidney disease, and may be a useful adjunct to assess relative intravascular volume in patients with kidney disease.

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“…A meta‐analysis of 3 pediatric and 14 adult studies demonstrated moderate predictive value of IVC respiratory variation in spontaneously breathing and mechanically ventilated patients in acute circulatory failure with pooled sensitivity of 0.63 [95% confidence interval (CI) 0.56‐0.69], specificity of 0.73 (95% CI 0.67‐0.78), and area under the receiver operating characteristic curve of 0.79 (Figure ) . The test characteristics of IVC respiratory variation have been shown to perform better in mechanically ventilated patients (best in those with a tidal volume >8 mL/kg) as compared to spontaneously breathing patients . Due to the heterogeneity of the existing literature, there are insufficient data to inform accepted pediatric‐specific cutoffs to predict fluid responsiveness.…”

Section: Diagnostic Applicationsmentioning

confidence: 99%

Getting to know a familiar face: Current and emerging focused ultrasound applications for the perioperative setting

Conlon

Lin

Bruins

et al. 2019

Pediatric Anesthesia

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Ultrasound technology is available in many pediatric perioperative settings. There is an increasing number of ultrasound applications for anesthesiologists which may enhance clinical performance, procedural safety, and patient outcomes. This review highlights the literature and experience supporting focused ultrasound applications in the pediatric perioperative setting across varied disciplines including anesthesiology. The review also suggests strategies for building educational and infrastructural systems to translate this technology into clinical practice. K E Y W O R D S anesthesiology, echocardiography, education, nerve block, patient safety, ultrasonography | 673 CONLON et aL. How to cite this article: Conlon TW, Lin EE, Bruins BB, et al. Getting to know a familiar face: Current and emerging focused ultrasound applications for the perioperative setting. Pediatr

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Does respiratory variation of inferior vena cava diameter predict fluid responsiveness in spontaneously ventilating children with sepsis

Abstract: IVC collapsibility has poor test characteristics for predicting fluid responsiveness in spontaneously ventilating children with sepsis.

Cited by 27 publications

References 51 publications

Caudal vena cava collapsibility index as a tool to predict fluid responsiveness in dogs

Caudal vena cava collapsibility index as a tool to predict fluid responsiveness in dogs

<p>Comparison of Respiratory Variations of Subclavian Vein and Inferior Vena Cava in Hospitalized Patients with Kidney Disease</p>

Getting to know a familiar face: Current and emerging focused ultrasound applications for the perioperative setting

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