The utility of stroke volume variability as a predictor of fluid responsiveness in critically ill children: a pilot study

McLean, Jack R. L.; Inwald, David

doi:10.1007/s00134-013-3171-x

Cited by 7 publications

(13 citation statements)

References 5 publications

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“…Reasons for exclusion are detailed in S2 File . Consequently, six studies were ultimately included in our analysis [ 13 , 14 , 20 – 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…All of the studies were published from 2012 to 2015. Totally 279 fluid boluses were given in 224 children, as two studies used multiple fluid boluses in some patients [ 13 , 20 ]. In the majority of studies, the patients were mechanically ventilated with tidal volumes of 10 ml/kg.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies used colloids as fluid bolus, one study used crystalloid, and one study did not report type of fluid given. Four studies were performed in the operating room during congenital heart surgery or craniosynostosis repair [ 14 , 21 – 23 ], and two studies were performed in the PICU [ 13 , 20 ]. SVV was tested by non-invasive measures such as NICOM (non-invasive cardiac output monitor) and USCOM (ultrasonic cardiac output monitor) in four studies, whereas two studies used invasive measures including PiCCO (pulse index continuous cardiac output) and Mostcare.…”

Section: Resultsmentioning

confidence: 99%

“…SVV was tested by non-invasive measures such as NICOM (non-invasive cardiac output monitor) and USCOM (ultrasonic cardiac output monitor) in four studies, whereas two studies used invasive measures including PiCCO (pulse index continuous cardiac output) and Mostcare. In the majority of studies, fluid responsiveness was defined as change in stroke volume index (SVI) of at least 15%, except one study used a threshold of 10% [ 20 ]. The quality of the included studies were assessed by Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) available in Table 2 [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

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Does stroke volume variation predict fluid responsiveness in children: A systematic review and meta-analysis

Liu

Qiao

et al. 2017

PLoS ONE

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ObjectiveStroke volume variation (SVV) is a reliable predictor of fluid responsiveness in adult patients. However, the predictive value of SVV is uncertain in pediatric patients. We performed the first systematic meta-analysis to evaluate the diagnostic value of SVV in predicting fluid responsiveness in children.MethodsPUBMED, EMBASE, and Cochrane Central Register of Controlled Trials were searched up to December 2016. Original studies assessing the diagnostic accuracy of SVV in predicting fluid responsiveness in children were considered to be eligible. A random-effects model was used to calculate pooled values of sensitivity, specificity and diagnostic odds ratio with 95% CI. The summary receiver operating characteristic curve was estimated and area under the curve was calculated. Quality of the studies was assessed with the QUADAS-2 tool.ResultsSix studies with a total of 279 fluid boluses in 224 children were included. The analysis demonstrated a pooled sensitivity of 0.68 (95% CI,0.59–0.76), pooled specificity of 0.65 (95% CI, 0.57–0.73), pooled diagnostic odds ratio of 8.24 (95% CI, 2.58–26.30), and the summary area under the summary receiver operating characteristic curve of 0.81. However, significant inter-study heterogeneity was found (p<0.05, I2 = 61.3%), likely due to small sample size and diverse study characteristics.ConclusionsCurrent evidence suggests that SVV was of diagnostic value in predicting fluid responsiveness in children under mechanical ventilation. Given the high heterogeneity of published data, further studies are needed to confirm the diagnostic accuracy of SVV in predicting fluid responsiveness in pediatric patients.

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“…Reasons for exclusion are detailed in S2 File . Consequently, six studies were ultimately included in our analysis [ 13 , 14 , 20 – 23 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Does stroke volume variation predict fluid responsiveness in children: A systematic review and meta-analysis

Liu

Qiao

et al. 2017

PLoS ONE

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“…Future prospective studies with improved hemodynamic monitoring may help to dissect this association (17). There are a two possible explanations-first, that fluid bolus therapy is being given at the point the Starling curve is flat, or in other words, a failure to respond to fluids alerts the clinician that vasoactive drugs are required; or second, that patients on vasoactive drugs are more unwell with more capillary leak and simply require increased fluids.…”

Section: Discussionmentioning

confidence: 99%

Fluid Overload at 48 Hours Is Associated With Respiratory Morbidity but Not Mortality in a General PICU

Sinitsky

Walls

Nadel

et al. 2015

Pediatric Critical Care Medicine

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111

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Assessing Fluid Responsiveness Using Noninvasive Hemodynamic Monitoring in Pediatric Shock: A Review

Shah

Patel

Awadhare

et al. 2023

J Pediatr Intensive Care

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Noninvasive hemodynamic monitoring devices have been introduced to better quantify fluid responsiveness in pediatric shock; however, current evidence for their use is inconsistent. This review aims to examine available noninvasive hemodynamic monitoring techniques for assessing fluid responsiveness in children with shock. A comprehensive literature search was conducted using PubMed and Google Scholar, examining published studies until December 31, 2022. Articles were identified using initial keywords: [noninvasive] AND [fluid responsiveness]. Inclusion criteria included age 0 to 18, use of noninvasive techniques, and the emergency department (ED) or pediatric intensive care unit (PICU) settings. Abstracts, review papers, articles investigating intraoperative monitoring, and non-English studies were excluded. The methodological index for nonrandomized studies (MINORS) score was used to assess impact of study bias and all study components were aligned with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Our review yielded 1,353 articles, 17 of which met our inclusion criteria, consisting of 618 patients. All were prospective observational studies performed in the ED (n = 3) and PICU (n = 14). Etiologies of shock were disclosed in 13/17 papers and consisted of patients in septic shock (38%), cardiogenic shock (29%), and hypovolemic shock (23%). Noninvasive hemodynamic monitors included transthoracic echocardiography (TTE) (n = 10), ultrasonic cardiac output monitor (USCOM) (n = 1), inferior vena cava ultrasonography (n = 2), noninvasive cardiac output monitoring (NICOM)/electrical cardiometry (n = 5), and >2 modalities (n = 1). To evaluate fluid responsiveness, most commonly examined parameters included stroke volume variation (n = 6), cardiac index (CI) (n = 6), aortic blood flow peak velocity (∆V peak) (n = 3), and change in stroke volume index (n = 3). CI increase >10% predicted fluid responsiveness by TTE in all ages; however, when using NICOM, this increase was only predictive in children >5 years old. Additionally, ∆SV of 10 to 13% using TTE and USCOM was deemed predictive, while no studies concluded distensibility index by transabdominal ultrasound to be significantly predictive. Few articles explore implications of noninvasive hemodynamic monitors in evaluating fluid responsiveness in pediatric shock, especially in the ED setting. Consensus about their utility remains unclear, reiterating the need for further investigations of efficacy, accuracy, and applicability of these techniques.

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The utility of stroke volume variability as a predictor of fluid responsiveness in critically ill children: a pilot study

Cited by 7 publications

References 5 publications

Does stroke volume variation predict fluid responsiveness in children: A systematic review and meta-analysis

Does stroke volume variation predict fluid responsiveness in children: A systematic review and meta-analysis

Fluid Overload at 48 Hours Is Associated With Respiratory Morbidity but Not Mortality in a General PICU

Assessing Fluid Responsiveness Using Noninvasive Hemodynamic Monitoring in Pediatric Shock: A Review

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