Fluid Responsiveness Predictability in Immediate Postoperative Pediatric Cardiac Surgery. Is the Old Slandered Central Venous Pressure Back Again?

Shostak, Eran; Shochat, Tzippy; Manor, Orit; Nahum, Elchanan; Dagan, Ovadia; Schiller, Ofer

doi:10.1097/shk.0000000000001786

Cited by 7 publications

(12 citation statements)

References 34 publications

(47 reference statements)

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“…Additional data provided by authors Eran Shostak and Ji-Hyun Lee were used in the meta-analysis. 12,32 ∆VPeak was found to be a predictor of fluid responsiveness in all studies evaluating its accuracy, with AUC ranging from 0.71 to 1.00. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] The cut-off values for ∆VPeak in the included studies ranged from 10% to 20%.…”

Section: Data Synthesis and Meta-analysismentioning

confidence: 93%

“…The most studied predictors was the ∆VPeak, [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] followed by the ∆IVC, 13,19,23,25,27,[29][30][31][32][33] the respiratory variation in aortic velocity-time integral (∆VTI), 18,22,28 and the aortic corrected flow time (FTc). 29,32,34 Eleven studies were conducted in operating rooms, 14-17, 21-23, 26-28, 35 twelve in pediatric intensive care units (PICUs), 12,13,[18][19][20]25,29,[31][32][33][34] one in an emergency department (ED), 30 and one involved both the ED and the PICU. 36 The vast majority of participants were under controlled mechanical ventilation (93.6%), with tidal volumes ranging from 8 to 10 ml/kg in fifteen studies.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…12,18,21,30,33 Colloids solutions were used in nine stu dies, 13,14,17,[22][23][24]26,29,34 crystalloids in ten, 15,16,18,20,21,27,30,32,33,36 and three used both. 12,19,35 Transthoracic echocardiography (TTE) was the most used reference standard to assess fluid responsiveness, 12,13,15,[17][18][19][20][21][23][24][25]29,[31][32][33]37 followed by transesophageal echocardiography (TEE). 14,16,22,26,27,29,34,35 Sixtee...…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…18,27 Eight studies that evaluated the ∆IVC were included in the metaanalysis. 19,25,27,[29][30][31][32][33] The studies conducted by Byon et al and Choi et al did not present sensitivity and specificity estimates and thus were not included in the pooled analysis. 13,23 The pooled sensitivity of ∆IVC was 0.79 (95% CI, 0.64-0.89), whereas the pooled specificity was 0.69 (95% CI, 0.52-0.81), and its PLR and NLR were 2.5 (95% CI, 1.4-4.6) and 0.31 (95% CI, 0.14-0.67), respectively (Figure 4).…”

Section: Data Synthesis and Meta-analysismentioning

confidence: 99%

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Point‐of‐care ultrasonography to predict fluid responsiveness in children: A systematic review and meta‐analysis

Carioca

Souza

et al. 2022

Pediatric Anesthesia

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Background Point‐of‐care ultrasonography (POCUS) is proposed as a valuable method for hemodynamic monitoring and several ultrasound‐based predictors of fluid responsiveness have been studied. The main objective of this study was to assess the accuracy of these predictors in children. Methods PubMed, Embase, Scopus, http://clinicaltrials.gov, and Cochrane Library databases were searched for relevant publications through July 2022. Pediatric studies reporting accuracy estimates of ultrasonographic predictors of fluid responsiveness were included since they had used a standard definition of fluid responsiveness and had performed an adequate fluid challenge. Results Twenty‐three studies involving 1028 fluid boluses were included, and 12 predictors were identified. A positive response to fluid infusion was observed in 59.7% of cases. The vast majority of participants were mechanically ventilated (93.4%). The respiratory variation in aortic blood flow peak velocity (∆Vpeak) was the most studied predictor, followed by the respiratory variation in inferior vena cava diameter (∆IVC). The pooled sensitivity and specificity of ∆Vpeak were 0.84 (95% CI, 0.76–0.90) and 0.82 (95% CI, 0.75–0.87), respectively, and the area under the summary receiver operating characteristic curve (AUSROC) was 0.89 (95% CI, 0.86–0.92). The ∆IVC presented a pooled sensitivity and specificity of 0.79 (95% CI, 0.62–0.90) and 0.70 (95% CI, 0.51–0.84), respectively, and an AUSROC of 0.81 (95% CI, 0.78–0.85). Significant heterogeneity in accuracy estimates across studies was observed. Conclusions POCUS has the potential to accurately predict fluid responsiveness in children. However, only ∆Vpeak was found to be a reliable predictor. There is a lack of evidence supporting the use of POCUS to guide fluid therapy in spontaneously breathing children.

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Section: Data Synthesis and Meta-analysismentioning

confidence: 93%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

Section: Data Synthesis and Meta-analysismentioning

confidence: 99%

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Point‐of‐care ultrasonography to predict fluid responsiveness in children: A systematic review and meta‐analysis

Carioca

Souza

et al. 2022

Pediatric Anesthesia

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“…Data were included from a total of 15 studies published between 2008 and 2021 2–16 . Study identification is detailed in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Fluid bolus administration in children, who responds and how? A systematic review and meta‐analysis

Loomba

Villarreal

Farias

et al. 2022

Pediatric Anesthesia

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Background: Fluid boluses are frequently utilized in children. Despite their frequency of use, there is little objective data regarding the utility of fluid boluses, who they benefit the most, and what the effects are.Aims: This study aimed to conduct pooled analyses to identify those who may be more likely to respond to fluid boluses as well as characterize clinical changes associated with fluid boluses. Methods:A systematic review of the literature and meta-analysis was conducted to identify pediatric studies investigating the response to fluid boluses and clinical changes associated with fluid boluses.Results: A total of 15 studies with 637 patients were included in the final analyses with a mean age of 650 days ± 821.01 (95% CI 586 to 714) and a mean weight of 10.5 kg ± 7.19 (95% CI 9.94 to 11.1). The mean bolus volume was 12.14 ml/kg ± 4.09 (95% CI 11.8 to 12.5) given over a mean of 19.55 min ± 10.16 (95% CI 18.8 to 20.3).How to cite this article: Loomba RS, Villarreal EG, Farias JS, Flores S, Bronicki RA. Fluid bolus administration in children, who responds and how? A systematic review and metaanalysis.

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Accuracy of Respiratory Variation in Inferior Vena Cava Diameter to Predict Fluid Responsiveness in Children Under Mechanical Ventilation

et al. 2023

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Fluid Responsiveness Predictability in Immediate Postoperative Pediatric Cardiac Surgery. Is the Old Slandered Central Venous Pressure Back Again?

Cited by 7 publications

References 34 publications

Point‐of‐care ultrasonography to predict fluid responsiveness in children: A systematic review and meta‐analysis

Point‐of‐care ultrasonography to predict fluid responsiveness in children: A systematic review and meta‐analysis

Fluid bolus administration in children, who responds and how? A systematic review and meta‐analysis

Accuracy of Respiratory Variation in Inferior Vena Cava Diameter to Predict Fluid Responsiveness in Children Under Mechanical Ventilation

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