Journal article

Does respiratory variation of inferior vena cava diameter predict fluid responsiveness in spontaneously ventilating children with sepsis

Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl

EMERGENCY MEDICINE AUSTRALASIA | WILEY | Published : 2018

Abstract

OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure. IVC ultrasound was performed prior to FBT. Trans-thoracic echocardiography was performed prior to, 5 and 60 min after FBT. IVC collapsibility index and stroke distance were calculated by a blinded Paediatric Em..

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Grants

Awarded by Windermere Foundation Doctoral Scholarship in Health, a National Health and Medical Research Council Centre of Research Excellence Grant for Paediatric Emergency Medicine, Canberra, ACT, Australia


Funding Acknowledgements

The authors thank the resuscitation staff in the ED of The Royal Children's Hospital, Melbourne, Australia, for their enthusiasm and help recruiting patients for the present study. They also thank the families of enrolled children for allowing study procedures to be performed during a stressful time of their hospitalisation. Last, the authors thank the children who acted as study participants for their involvement, improving their care was the primary motivator for the present study. The present study was supported in part by a Windermere Foundation Doctoral Scholarship in Health, a National Health and Medical Research Council Centre of Research Excellence Grant for Paediatric Emergency Medicine (GNT1058560), Canberra, ACT, Australia, the Victorian Governments Infrastructure Support Program, Melbourne, Australia, a Shields Research Entry Scholarship provided by the Royal Australasian College of Physicians, Sydney, NSW, Australia, and a Clinical Sciences Theme Grant provided by The Royal Children's Hospital Foundation, Melbourne, VIC, Australia. FEB was supported by a Melbourne Children's Clinician Scientist Fellowship, Melbourne, Australia, and a NHMRC Practitioner Fellowship.