Circulatory Failure Clinical Trial
Official title:
Fluid Responsiveness Evaluation by AbdomiNal Compression in Kids Based on the STARLING Concept
Purpose:
Fluid responsiveness in a context of circulatory failure can be predicted by different way.
Dynamic criteria such as pulse pressure variation, stroke volume variation during an
end-expiratory occlusion maneuver or a passive leg raising have been reported to predict
fluid responsiveness. Only aortic velocity peak variation measured with transthoracic
echocardiography during mechanical ventilation has been reported to predict fluid
responsiveness in children. Besides some physician use a maneuver of abdominal compression
to predict fluid responsiveness in children with circulatory failure. This strategy has
never been formally evaluated.
The investigators will study the diagnosis accuracy of the stroke volume variation induced
by an abdominal compression to predict stroke volume variation after 10 ml/kg fluid load in
children with circulatory failure.
Thirty-eight pediatric patients under eight years old in circulatory failure, for whom the
attending physician has decided a fluid load will be included. Hemodynamic parameters:
arterial pressure, heart rate, stroke volume measured with echocardiography; will be
recorded. This data collection will be performed before, after abdominal compression and
after a fluid load of 10 ml/kg.
Patients will be aposteriori sorted in two groups: Fluid responders and Fluid
non-responders. Fluid responders are defined as patients that show an increase greater than
15 % in stroke volume. The diagnosis ability of the Stroke volume variation after an
abdominal compression to predict fluid responsiveness will be investigate and receiving
operative characteristic (ROC) curve will be built. The correlation between the variation of
stroke volume during abdominal compression and during the fluid load will be studied. Other
parameters such as arterial pressure and heart rate will also be investigated.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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