Hypovolemia Clinical Trial
Official title:
Prediction of Fluid Responsiveness Using Respiratory Variation in Pulse Oximeter Plethysmography in Children Undergoing Major Surgery
The purpose of this study is to evaluate predictability of a respiratory variation in pulse oximeter plethysmography for fluid responsiveness in children undergoing major surgery.
The purpose of this study is to evaluate predictability of a a respiratory variation in pulse
oximeter plethysmography (delta POP) for fluid responsiveness in children undergoing major
surgery.
When there are clinical signs of hypovolemia, such as hypotension, decreased urine output and
central venous pressure less than 5 mmHg, the study will be started. At index fingers of both
hand, pulse oximeter sensors are applied by gradually increasing the contact force (from 0 to
1.4N, being increased by 0.2-0.3N). Then, pulse oximeter plethysmography (POP) waveforms are
obtained for 90 seconds. Then, intravenous crystalloid fluid 10 mL/kg is infused for 15 min.
To evaluate the change of cardiac output, transesophageal or transthoracic echocardiography
is performed before and after fluid administration. In addition, hemodynamic parameters
including pulse pressure variation, systolic pressure variation, pleth variability index and
central venous pressure are also recorded before and after fluid administration.
Finally, patients will be divided into fluid responder group and non-responder group. If
stroke volume index measured using echocardiography increases over 15% after fluid
administration, the patient will be fluid responder.
Delta POP (%) obtained from each finger with different contact force is calculated as
follows;(POPmax - POPmin)/{(POPmax + POPmin)/2}. Using receiver operating characteristic
curve, diagnostic power of delta POPs from different contact forces for fluid responsiveness
will be evaluated. In addition, difference between delta POP from low contact force and that
from high contact force will be evaluated.
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