PMID- 30442260
OWN - NLM
STAT- MEDLINE
DCOM- 20190115
LR  - 20190115
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Linking)
VI  - 121
IP  - 6
DP  - 2018 Dec
TI  - Diagnostic accuracy of a calibrated abdominal compression to predict fluid 
      responsiveness in children.
PG  - 1323-1331
LID - S0007-0912(18)30635-4 [pii]
LID - 10.1016/j.bja.2018.06.030 [doi]
AB  - BACKGROUND: Fluid administration to increase stroke volume index (SVi) is a 
      cornerstone of haemodynamic resuscitation. We assessed the accuracy of SVi 
      variation during a calibrated abdominal compression manoeuvre (DeltaSVi-CAC) to 
      predict fluid responsiveness in children. METHODS: Patients younger than 8 yr 
      with acute circulatory failure, regardless of their ventilation status, were 
      selected. SVi, calculated as the average of five velocity-time integrals 
      multiplied by the left ventricular outflow tract surface area, was recorded at 
      four different steps: baseline, after an abdominal compression with a calibrated 
      pressure of 25 mm Hg, after return to baseline, and then after a volume expansion 
      (VE) of 10 ml kg(-1) lactated Ringer solution over 10 min. Patients were 
      classified as responders if SVi variation after volume expansion (DeltaSVi-VE) 
      increased by at least 15%. RESULTS: The 39 children included had a median 
      [inter-quartile range (IQR)] age of 9 [5-31] months. Twenty patients were fluid 
      responders and 19 were non-responders. DeltaSVi-CAC correlated with DeltaSVi-VE (r=0.829; 
      P<0.001). The area under the receiver operating characteristic curve (ROC(AUC)) 
      was 0.94 [95% confidence interval (CI), 0.85-0.99]. The best threshold for 
      DeltaSVi-CAC was 11% with a specificity of 95% [95% CI, 84-100] and a sensitivity of 
      75% [95% CI, 55-95]. ROC(AUC) of respiratory variation of IVC diameter (DeltaIVC) was 
      0.53 [95% CI, 0.32-0.72]. CONCLUSION: DeltaSVi-CAC during abdominal compression was a 
      reliable method to predict fluid responsiveness in children with acute 
      circulatory failure regardless of their ventilation status. CLINICAL TRIALS 
      REGISTRATION: CPP Lyon sud est II: n degrees  ANSM 2015-A00388-41 Clinicaltrial.gov: 
      NCT02505646.
CI  - Copyright (c) 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Jacquet-Lagreze, M
AU  - Jacquet-Lagreze M
AD  - Departement d'Anesthesie Reanimation, Centre Hospitalier Louis Pradel, Bron, 
      France; Universite Claude-Bernard Lyon 1, Campus Lyon Sante Est, Lyon, France. 
      Electronic address: matthias.jl@gmail.com.
FAU - Tiberghien, N
AU  - Tiberghien N
AD  - Departement d'Anesthesie Reanimation, Centre Hospitalier Louis Pradel, Bron, 
      France.
FAU - Evain, J-N
AU  - Evain JN
AD  - Departement de Reanimation Pediatrique, Centre Hospitalier Femme Mere Enfant, 
      Bron, France.
FAU - Hanna, N
AU  - Hanna N
AD  - Departement d'Anesthesie Reanimation, Centre Hospitalier Louis Pradel, Bron, 
      France.
FAU - Courtil-Teyssedre, S
AU  - Courtil-Teyssedre S
AD  - Departement de Reanimation Pediatrique, Centre Hospitalier Femme Mere Enfant, 
      Bron, France.
FAU - Lilot, M
AU  - Lilot M
AD  - Departement d'Anesthesie Pediatrique, Centre Hospitalier Femme Mere Enfant, Bron, 
      France; Universite Claude-Bernard Lyon 1, Campus Lyon Sante Est, Lyon, France; 
      Centre Lyonnais d'Enseignement par Simulation en Sante, SAMSEI, Lyon, France; 
      Health Services and Performance Research Laboratory, Universite Claude Bernard 
      Lyon 1, Lyon, France.
FAU - Baudin, F
AU  - Baudin F
AD  - Departement de Reanimation Pediatrique, Centre Hospitalier Femme Mere Enfant, 
      Bron, France; Universite Claude-Bernard Lyon 1, Campus Lyon Sante Est, Lyon, 
      France.
FAU - Chardonnal, L
AU  - Chardonnal L
AD  - Departement d'Anesthesie Reanimation, Centre Hospitalier Louis Pradel, Bron, 
      France.
FAU - Bompard, D
AU  - Bompard D
AD  - Departement d'Anesthesie Reanimation, Centre Hospitalier Louis Pradel, Bron, 
      France.
FAU - Koffel, C
AU  - Koffel C
AD  - Departement d'Anesthesie Reanimation, Centre Hospitalier Louis Pradel, Bron, 
      France.
FAU - Portefaix, A
AU  - Portefaix A
AD  - EPICIME-CIC 1407 de Lyon, Inserm, Hospices Civils de Lyon, Bron, France.
FAU - Javouhey, E
AU  - Javouhey E
AD  - Departement de Reanimation Pediatrique, Centre Hospitalier Femme Mere Enfant, 
      Bron, France; Universite Claude-Bernard Lyon 1, Campus Lyon Sante Est, Lyon, 
      France.
FAU - Fellahi, J-L
AU  - Fellahi JL
AD  - Departement d'Anesthesie Reanimation, Centre Hospitalier Louis Pradel, Bron, 
      France; Universite Claude-Bernard Lyon 1, Campus Lyon Sante Est, Lyon, France.
LA  - eng
SI  - ClinicalTrials.gov/NCT02505646
PT  - Journal Article
DEP - 20180906
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
SB  - IM
MH  - Abdomen
MH  - Calibration
MH  - Child, Preschool
MH  - Female
MH  - *Fluid Therapy
MH  - Humans
MH  - Infant
MH  - Male
MH  - Pressure
OTO - NOTNLM
OT  - echocardiography
OT  - goal-directed fluid management
OT  - hypovolaemia
OT  - shock
OT  - volume expansion
EDAT- 2018/11/18 06:00
MHDA- 2019/01/16 06:00
CRDT- 2018/11/17 06:00
PHST- 2017/11/03 00:00 [received]
PHST- 2018/05/24 00:00 [revised]
PHST- 2018/06/27 00:00 [accepted]
PHST- 2018/11/17 06:00 [entrez]
PHST- 2018/11/18 06:00 [pubmed]
PHST- 2019/01/16 06:00 [medline]
AID - S0007-0912(18)30635-4 [pii]
AID - 10.1016/j.bja.2018.06.030 [doi]
PST - ppublish
SO  - Br J Anaesth. 2018 Dec;121(6):1323-1331. doi: 10.1016/j.bja.2018.06.030. Epub 
      2018 Sep 6.