Cardiac Output Assessment using Echocardiography in Critically Ill Children in Pediatric in Intensive Care Unit (PICU)

Background: We used a TTE as a noninvasive hemodynamic monitoring to assess fluid responsiveness in children with ACF in our PICU

Objective: Our study aimed to investigate if static indices using TTE at baseline can predict fluid responsiveness in spontaneously breathing patients with ACF in PICU

Methods: In this prospective, observational and interventional study conducted in our PICU from January 2012 to December 2017; we investigated 15 spontaneously breathing patients with acute circulatory failure (ACF). We measured velocity time integral (VTI), strok volume index (SVi) and cardiac index for each patient using TTE.

Results: The prediction of fluid responsiveness using 25 bolus in 15 patients was higher with VTI (ROC curve area 0.88 (95% IC = 0,69 to 0,97); P=0.001), than with SVi and CI (ROC curve area 0.63 (95% IC = 0,42-0,81); P=NS), 0.57 (95% IC = 0,37-0,77); P=NS), and 0.660 (95% CI, 0,526 - 0,777; P= 0.158) respectively.

The best cutoff value for VTI, SVi and CI was less than or equal to 24,2 cm, 26 ml/m2 and 4,23 l/mn/m2 with sensitivity and specificity of 100% and 66,6%, 45,4% and 100% and 68,2% and 66,6% respectively.

Conclusion: In this study, VTI was the most appropriate variable to predict fluid responsiveness in spontaneously breathing patients with ACF in PICU.