Diagnostic accuracy of a calibrated abdominal compression to predict fluid responsiveness in children
Résumé
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 (?SVi-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 (?SVi-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. ?SVi-CAC correlated with ?SVi-VE (r=0.829; P