Suprasternal notch echocardiography: a potential alternative for the measurement of respiratory variation in aortic blood flow peak velocity in mechanically ventilated children

Devauchelle, Pauline; Siqueira, Mathilde De Queiroz; Lilot, Marc; Chassard, D.; Desgranges, François-Pierrick

doi:10.1007/s10877-017-0039-6

Cited by 5 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This method is useful when access to the chest wall is limited during surgery. A significant relationship between the ΔVpeak recorded via the suprasternal notch view and that recorded via the apical 5-chamber view (r = 0.62, P = 0.003) has been previously reported [34].…”

Section: Potential Predictors Of Fluid Responsivenesmentioning

confidence: 64%

Fluid responsiveness in the pediatric population

Lee

Kim

Jang

et al. 2019

Korean J Anesthesiol

View full text Add to dashboard Cite

It is challenging to predict fluid responsiveness, that is, whether the cardiac index or stroke volume index would be increased by fluid administration, in the pediatric population. Previous studies on fluid responsiveness have assessed several variables derived from pressure wave measurements, plethysmography (pulse oximeter plethysmograph amplitude variation), ultrasonography, bioreactance data, and various combined methods. However, only the respiratory variation of aortic blood flow peak velocity has consistently shown a predictive ability in pediatric patients. For the prediction of fluid responsiveness in children, flow- or volume-dependent, noninvasive variables are more promising than pressure-dependent, invasive variables. This article reviews various potential variables for the prediction of fluid responsiveness in the pediatric population. Differences in anatomic and physiologic characteristics between the pediatric and adult populations are covered. In addition, some important considerations are discussed for future studies on fluid responsiveness in the pediatric population.

show abstract

Section: Potential Predictors Of Fluid Responsivenesmentioning

confidence: 64%

Fluid responsiveness in the pediatric population

Lee

Kim

Jang

et al. 2019

Korean J Anesthesiol

View full text Add to dashboard Cite

show abstract

“…Previous studies have identified the relationship between fluid responsiveness and respiratory variation in the arterial blood flow peak velocity in the ascending aorta and/ or the proximal branches of the aorta. 7,8,22 We also observed the respiratory variation of the internal carotid artery blood flow peak velocity when we checked the blood flow to the brain using transfontanelle Doppler ultrasound. The purpose of this study was to evaluate the potential role of point-of-care transfontanelle ultrasonography by determining whether the respiratory variation of the internal carotid artery blood flow peak velocity measured by transfontanelle Doppler ultrasound can predict fluid responsiveness in pediatric cardiac patients.…”

Section: What We Already Know About This Topicmentioning

confidence: 99%

Respiratory Variation of Internal Carotid Artery Blood Flow Peak Velocity Measured by Transfontanelle Ultrasound to Predict Fluid Responsiveness in Infants

et al. 2019

View full text Add to dashboard Cite

Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Cranial sonography is a widely used point-of-care modality in infants. The authors evaluated that the respiratory variation of the internal carotid artery blood flow peak velocity as measured using transfontanelle ultrasound can predict fluid responsiveness in infants. Methods This prospective observational study included 30 infants undergoing cardiac surgery. Following closure of the sternum, before and after the administration of 10ml · kg–1 crystalloid, the respiratory variation of the aorta blood flow peak velocity, pulse pressure variation, and central venous pressure were obtained. The respiratory variation of the internal carotid artery blood flow peak velocity was measured using transfontanelle ultrasound. Response to fluid administration was defined as an increase in stroke volume index, as measured with transesophageal echocardiography, greater than 15% of baseline. Results Seventeen subjects (57%) were responders to volume expansion. Before fluid loading, the respiratory variation of the internal carotid artery and the aorta blood flow peak velocity (means ± SD) of the responders were 12.6 ± 3.3% and 16.0 ± 3.8%, and those of the nonresponders were 8.2 ± 3.2% and 10.9 ± 3.5%, respectively. Receiver operating characteristic curve analysis showed that the respiratory variation of the internal carotid artery and the aorta blood flow peak velocity could predict fluid responsiveness; the area under the curve was 0.828 (P < 0.0001; 95% CI, 0.647 to 0.940) and 0.86 (P = 0.0001; 95% CI, 0.684 to 0.959), respectively. The cutoff values of the respiratory variation of the internal carotid artery and the aorta blood flow peak velocity were 7.8% (sensitivity, 94%; specificity, 69%) and 13% (sensitivity, 77%; specificity, 92%), respectively. Conclusions The respiratory variation of the internal carotid artery blood flow peak velocity as measured using transfontanelle ultrasound predicted an increase in stroke volume in response to fluid. Further research is required to establish any wider generalizability of the results.

show abstract

“…ΔVpeak can also be measured via the suprasternal notch view, which has more practicality during surgery compared to the apical 5-chamber view 41,42 . Other variants of this technique have been deduced.…”

Section: Fluid Responsivenessmentioning

confidence: 99%

Perioperative fluid management in children: an updated review

Beels¹,

Stevens²,

Saldien³

2022

Acta Anaest Belg

View full text Add to dashboard Cite

Background: Perioperative fluid management in children has been a major topic for debate. Objectives: Our aim is to review the current evidence on perioperative fluid management in children including: type of fluid, administration rates, preoperative fluid intake and monitoring techniques. Design: Narrative review. Method: Following the PRISMA-S guidelines we performed a search (2010-March 2022) in databases Medline (through PubMed) and Cochrane Library. 4297 citations were found and screened by two independent researchers. After screening, 64 articles were withheld for our review. Results: The perioperative administration of isotonic fluids is safer than hypotonic solutions, concerning the development of hyponatremia. A balanced isotonic solution with 1-2,5% glucose should be used as perioperative maintenance IV fluid in children (1 month to 18 years). Colloids can be used in children when inadequate effect in volume correction is achieved with crystalloids. The preferred synthetic colloid for children is a third generation HES in a balanced solution. To date, most clinicians use the “4-2-1 rule” for calculating fluid rate. This may not be the optimal fluid rate, as little research has been done. Preoperative fasting for clear fluids should be limited to 1 hour, children should even be encouraged to drink up until 1 hour before induction. Respiratory variation of aortic blood flow peak velocity (ΔVpeak) with echocardiography is currently the most reliable technique for evaluating fluid responsiveness in children.

show abstract

Suprasternal notch echocardiography: a potential alternative for the measurement of respiratory variation in aortic blood flow peak velocity in mechanically ventilated children

Cited by 5 publications

References 6 publications

Fluid responsiveness in the pediatric population

Fluid responsiveness in the pediatric population

Respiratory Variation of Internal Carotid Artery Blood Flow Peak Velocity Measured by Transfontanelle Ultrasound to Predict Fluid Responsiveness in Infants

Perioperative fluid management in children: an updated review

Contact Info

Product

Resources

About