Application of Non-invasive Volume Parameters to Prediction of Fluid Responsiveness in Children Undergoing Congenital Heart Surgery
10.3870/j.issn.1672-0741.2017.05.020
- VernacularTitle:运用无创容量指标评价儿童先天性心脏病术后液体反应性
- Author:
Yuwei CHENG
1
;
Feng XU
;
Jing LI
Author Information
1. 重庆医科大学附属儿童医院 急诊科
- Keywords:
congenital heart disease;
ultrasonic cardiac output monitor;
stroke volume variation;
corrected flow time;
central venous pressure
- From:
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2017;46(5):593-599
- CountryChina
- Language:Chinese
-
Abstract:
Objective To use ultrasonic cardiac output monitor(USCOM)to monitor the hemodynamics of children who un-derwent congenital heart disease(CHD)surgery before and after fluid therapy,and to examine the accuracy of the hemodynamic parameters central venous pressure(CVP),stroke volume variation(SVV),corrected flow time(FTc)and smith madigan inotro-py index(SMII)in predicting fluid responsiveness of children post operation.Methods USCOM was used to monitor the hemo-dynamic parameters of post-operative children before and after fluid therapy.The change of SVI(ΔSVI)was calculated based on the stroke volume index(SVI)before and after fluid therapy,and the inotropic scores(IS)were obtained based on the doses of in-otropic drugs used.Children with ΔSVI≥ 15% were defined to be responders who responded to fluid resuscitation and those with ΔSVI < 15% as non-responders.Two subgroups were also established in terms of IS:IS ≤ 10 group and IS > 10 group.Results Among the parameters(CVP,FTc and SM,etc.),only the area under the ROC curve(AUC)of SVV was signifi-cantly different between before and after fluid therapy(AUC 0.776,P < 0.01).Subgrouping analysis also showed significant difference in only the AUC of SVV between IS≤ 10 group and IS> 10 group(AUC:0.732,P =0.045 or 0.813,P =0.002). Conclusion SVV monitored by USCOM,in contrast to CVP,FTc and SMII,can predict the fluid responsiveness in children af-ter congenital heart surgery.Prediction of fluid responsiveness by SVV shows higher accuracy in IS>10 group than in IS≤10 group.
