Using non invasive dynamic parameters of fluid responsiveness in children: there is still much to learn

Chung, Elena

doi:10.1007/s10877-012-9353-1

Cited by 14 publications

(12 citation statements)

References 22 publications

(25 reference statements)

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“…Pediatric patients are characterized by higher chest/lung compliance and higher vascular compliance, which may account for the mixed reported results for the use of dynamic parameters in this patient population [76]. …”

Section: Limitations Of Functional Hemodynamic Parametersmentioning

confidence: 99%

Bench-to-bedside review: Functional hemodynamics during surgery - should it be used for all high-risk cases?

2013

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The administration of a fluid bolus is done frequently in the perioperative period to increase the cardiac output. Yet fluid loading fails to increase the cardiac output in more than 50% of critically ill and surgical patients. The assessment of fluid responsiveness (the slope of the left ventricular function curve) prior to fluid administration may thus not only help in detecting patients in need of fluids but may also prevent unnecessary and harmful fluid overload. Unfortunately, commonly used hemodynamic parameters, including the cardiac output itself, are poor predictors of fluid responsiveness, which is best assessed by functional hemodynamic parameters. These dynamic parameters reflect the response of cardiac output to a preload-modifying maneuver (for example, a mechanical breath or passive leg-raising), thus providing information about fluid responsiveness without the actual administration of fluids. All dynamic parameters, which include the respiratory variations in systolic blood pressure, pulse pressure, stroke volume and plethysmographic waveform, have been repeatedly shown to be superior to commonly used static preload parameters in predicting the response to fluid loading. Within their respective limitations, functional hemodynamic parameters should be used to guide fluid therapy as part of or independently of goal-directed therapy strategies in the perioperative period.

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Section: Limitations Of Functional Hemodynamic Parametersmentioning

confidence: 99%

Bench-to-bedside review: Functional hemodynamics during surgery - should it be used for all high-risk cases?

2013

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“…27,[35][36][37][38][39][40][41][42][43][44][45] Probe position is also an important factor in acquiring good data. These are well documented more fully in the work of others.…”

Section: Reported Physiological Influences On the Pleth And Probe Posmentioning

confidence: 99%

A Review of Signal Processing Used in the Implementation of the Pulse Oximetry Photoplethysmographic Fluid Responsiveness Parameter

Addison

2014

Anesthesia &Amp; Analgesia

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ΔPOP is a physiological parameter derived from the respiration-induced change in the pulse oximetry plethysmographic (POP) waveform or "pleth." It has been proposed as a proxy for pulse pressure variation used in the determination of the response to intravascular volume expansion in hypovolemic patients. Many studies have now reported on the parameter, and many research groups have constructed algorithms for its computation from the first principles where the implementation details have been described. This review focuses on the signal processing aspects of ΔPOP, as reported in the literature, and aims to provide a comprehensive summary of the wide-ranging algorithmic strategies that have been attempted in its computation. A search was conducted for articles concerning the use of ΔPOP as a fluid responsiveness parameter. In particular, articles concerning the correlation between ΔPOP and pulse pressure variation were targeted. Comments and replies to comments by the authors in which signal processing aspects were discussed were also included in the review. The parameter is first defined, and a history of the early work surrounding pleth-based fluid responsiveness parameters is presented. This is followed by an overview of the signal processing methods used in the reported studies, including details of exclusion criteria, manual filtering (preprocessing), gain change issues, acquisition details, selection of registration periods, averaging methods, physiological influences on the pleth, and comments by the investigators themselves. It is concluded that to develop a robust, fully automated ΔPOP algorithm for use in the clinical environment, more rigorous signal processing is required. Specifically, signals should be evaluated over significant periods of time, with emphasis on the quality and temporal relevance of the information.

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“…Holliday and Segar addressed this issue, suggesting that the fluid prescription for the postoperative period should comprise an isotonic solution infused at a rate that is half of their 1957 prescription or 2/1/0.5 ml/kg/h ( Table 2), in which each infusion rate corresponds to the previous weight ranges. This cardiorespiratory interaction depends on at least two key variables: chest compliance and vascular compliance [47]. Additionally, it is important to know the serum sodium concentration, because it is a surrogate marker for cerebral edema [30 && ].…”

Section: Hyponatremia In the Postoperative Periodmentioning

confidence: 99%

Controversies in pediatric anesthesia

Gueli

Lerman

2013

Current Opinion in Anaesthesiology

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Using non invasive dynamic parameters of fluid responsiveness in children: there is still much to learn

Cited by 14 publications

References 22 publications

Bench-to-bedside review: Functional hemodynamics during surgery - should it be used for all high-risk cases?

Bench-to-bedside review: Functional hemodynamics during surgery - should it be used for all high-risk cases?

A Review of Signal Processing Used in the Implementation of the Pulse Oximetry Photoplethysmographic Fluid Responsiveness Parameter

Controversies in pediatric anesthesia

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