Prediction of stroke volume response to fluid bolus in 100 children
Critical Care volume 17, Article number: P207 (2013)
Fluid overload is associated with poor outcome in the critically ill. Thus, an accurate predictor of a positive haemodynamic response (increase in stroke volume) to fluid challenge is vital.
We studied the predictive value (positive response defined as change in stroke volume >15% after 10 ml/kg fluid bolus) of a range of haemodynamic variables: static (CVP, active circulating volume, central blood volume, total end diastolic volume), dynamic (systolic pressure variation, stroke volume variation) and contactility (dp/dt), in a group of 100 ventilated children (median weight 10 kg). Variables were measured using transpulmonary ultrasound dilution and PRAM (an arterial pulse contour method).
We performed 168 paired measurements (pre-fluid and post-fluid challenge), with a SV response rate of 45%. Overall predictive values were poor, but slightly better for static versus dynamic variables (Table 1). When SV response was analysed as a continuous variable, the two predictive multivariable variables were change in TEDVI and baseline dp/dt (r 2 = 0.30, both P < 0.001).
The predictive ability for typical static and dynamic haemodynamic variables, when taken in isolation, is poor. However, improved prediction is seen when baseline contractility is taken into account.
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Saxena, R., Durward, A., Murdoch, I. et al. Prediction of stroke volume response to fluid bolus in 100 children. Crit Care 17 (Suppl 2), P207 (2013). https://doi.org/10.1186/cc12145
- Stroke Volume
- Stroke Volume Variation
- Fluid Challenge
- Haemodynamic Response
- Pulse Contour