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Research article
xueying cai
Hangzhou First People's Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: There are few non-invasive monitoring methods that can reliably predict fluid responsiveness (FR) in children. Here, we interrogate the value of doppler ultrasound evaluation of passive leg raising (PLR)-induced changes in stroke volume (SV) and cardiac output (CO) as a predictor of FR in children with mechanical ventilation after congenital cardiac surgery.
Methods: A total of 40 children with mechanical ventilation following congenital cardiac surgery, who required volume expansion (VE) were included in this study. Hemodynamic parameters such as heart rate (HR), mean arterial pressure (MAP), SV, and central venous pressure (CVP) were monitored before and after PLR and VE. Besides, we assessed changes in SV and CO by bedside ultrasound. Patients showing >10% increase in SV in response to VE were considered to be responders (26 patients), while the rest (14 patients) were defined as non-responders.
Results: Our data demonstrated that ΔSV-PLR and ΔCO- PLR were positively correlated with ΔSV-VE (r = 0.683, p <0.001 and r = 0.374, p = 0.017, respectively), and the area under the ROC curve (AUC) of ΔSV-PLR was 0.879 (95% CI [0.745 1.000], p < 0.001). The best cut-off value for ΔSV-PLR in predicting FR was 13%, with its sensitivity and specificity were 81.8% and 86.3%, respectively. ΔCVP, ΔHR, and ΔMAP were weak predictors of FR in the children.
Conclusion: Our study demonstrated that SV changes, as evaluated by noninvasive ultrasound combined with PLR, could effectively evaluate FR in children under mechanical ventilation following congenital cardiac surgery.
Keywords
congenital heart surgery, fluid responsiveness, passive leg raising, ultrasound
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CURRENT STATUS: Published
View the published article at BMC Pediatrics.
Version 2
Posted 10 Aug, 2020
Community comments: 1
Editorial decision: Accept
On 04 May, 2021
Review #3 received
Received 29 Apr, 2021
Reviewer #3 agreed
On 19 Apr, 2021
Review #2 received
Received 16 Jan, 2021
Reviewer #2 agreed
On 08 Sep, 2020
Reviewer #1 agreed
On 06 Aug, 2020
Review #1 received
Received 06 Aug, 2020
Editor assigned
On 03 Aug, 2020
Reviewers invited
Invitations sent on 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jul, 2020
Reviewer #2 agreed
On 20 Jul, 2020
Review #2 received
Received 20 Jul, 2020
Reviewer #1 agreed
On 22 Apr, 2020
Review #1 received
Received 22 Apr, 2020
Reviewers invited
Invitations sent on 18 Mar, 2020
Editor assigned
On 10 Mar, 2020
Submission checks complete
On 09 Mar, 2020
Editor invited
On 09 Mar, 2020
First submitted
On 08 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Pediatrics.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
xueying cai
Hangzhou First People's Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pediatrics.
Version 2
Posted 10 Aug, 2020
Community comments: 1
Editorial decision: Accept
On 04 May, 2021
Review #3 received
Received 29 Apr, 2021
Reviewer #3 agreed
On 19 Apr, 2021
Review #2 received
Received 16 Jan, 2021
Reviewer #2 agreed
On 08 Sep, 2020
Reviewer #1 agreed
On 06 Aug, 2020
Review #1 received
Received 06 Aug, 2020
Editor assigned
On 03 Aug, 2020
Reviewers invited
Invitations sent on 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jul, 2020
Reviewer #2 agreed
On 20 Jul, 2020
Review #2 received
Received 20 Jul, 2020
Reviewer #1 agreed
On 22 Apr, 2020
Review #1 received
Received 22 Apr, 2020
Reviewers invited
Invitations sent on 18 Mar, 2020
Editor assigned
On 10 Mar, 2020
Submission checks complete
On 09 Mar, 2020
Editor invited
On 09 Mar, 2020
First submitted
On 08 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pediatrics.
Background: There are few non-invasive monitoring methods that can reliably predict fluid responsiveness (FR) in children. Here, we interrogate the value of doppler ultrasound evaluation of passive leg raising (PLR)-induced changes in stroke volume (SV) and cardiac output (CO) as a predictor of FR in children with mechanical ventilation after congenital cardiac surgery.
Methods: A total of 40 children with mechanical ventilation following congenital cardiac surgery, who required volume expansion (VE) were included in this study. Hemodynamic parameters such as heart rate (HR), mean arterial pressure (MAP), SV, and central venous pressure (CVP) were monitored before and after PLR and VE. Besides, we assessed changes in SV and CO by bedside ultrasound. Patients showing >10% increase in SV in response to VE were considered to be responders (26 patients), while the rest (14 patients) were defined as non-responders.
Results: Our data demonstrated that ΔSV-PLR and ΔCO- PLR were positively correlated with ΔSV-VE (r = 0.683, p <0.001 and r = 0.374, p = 0.017, respectively), and the area under the ROC curve (AUC) of ΔSV-PLR was 0.879 (95% CI [0.745 1.000], p < 0.001). The best cut-off value for ΔSV-PLR in predicting FR was 13%, with its sensitivity and specificity were 81.8% and 86.3%, respectively. ΔCVP, ΔHR, and ΔMAP were weak predictors of FR in the children.
Conclusion: Our study demonstrated that SV changes, as evaluated by noninvasive ultrasound combined with PLR, could effectively evaluate FR in children under mechanical ventilation following congenital cardiac surgery.
Figure 1
Figure 2
Figure 3
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