Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children

Shreepathi Krishna Achar, Maddani Shanmukhappa Sagar, Ranjan Shetty, Gurudas Kini, Jyothi Samanth, Chaitra Nayak, Vidya Madhu, Thara Shetty

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Aims: Dynamic parameters such as the respiratory variation in aortic flow peak velocity (ΔVpeak) and inferior vena cava distensibility index (dIVC) are accurate indices of fluid responsiveness in adults. Little is known about their utility in children. We studied the ability of these indices to predict fluid responsiveness in anaesthetised and mechanically ventilated children. Methods: This prospective study was conducted in 42 children aged between one to 14 years scheduled for elective surgery under general endotracheal anaesthesia. Mechanical ventilation was initiated with a tidal volume of 10 ml/kg. ΔVpeak, dIVC and stroke volume index (SVI) were measured before and after volume expansion (VE) with 10 ml/kg of crystalloid using transthoracic echocardiography. Patients were considered to be responders (R) and non-responders (NR) when SVI increased to either ≥15% or <15% after VE. ΔVpeak and dIVC were analysed between R and NR. Results: The best cut-off value for ΔVpeak as defined by the receiver operator characteristics (ROC) curve analysis was 12.2%, for which sensitivity, specificity, positive predictive value and negative predictive value were 100%, 94%, 96% and 100%, respectively, the area under the curve was 0.975. The best cut-off value for dIVC as defined by the ROC curve analysis was 23.5%, for which sensitivity, specificity, positive predictive value and negative predictive value were 91%, 89%, 91% and 89%, respectively, the area under the curve was 0.95. Conclusion: ΔVpeak and dIVC are reliable indices of fluid responsiveness in children.

Original languageEnglish
Pages (from-to)121-126
Number of pages6
JournalIndian Journal of Anaesthesia
Volume60
Issue number2
DOIs
Publication statusPublished - 01-02-2016

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Inferior Vena Cava
Stroke Volume
Area Under Curve
Endotracheal Anesthesia
Sensitivity and Specificity
Tidal Volume
Artificial Respiration
General Anesthesia
Echocardiography
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Achar, Shreepathi Krishna ; Sagar, Maddani Shanmukhappa ; Shetty, Ranjan ; Kini, Gurudas ; Samanth, Jyothi ; Nayak, Chaitra ; Madhu, Vidya ; Shetty, Thara. / Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children. In: Indian Journal of Anaesthesia. 2016 ; Vol. 60, No. 2. pp. 121-126.
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abstract = "Background and Aims: Dynamic parameters such as the respiratory variation in aortic flow peak velocity (ΔVpeak) and inferior vena cava distensibility index (dIVC) are accurate indices of fluid responsiveness in adults. Little is known about their utility in children. We studied the ability of these indices to predict fluid responsiveness in anaesthetised and mechanically ventilated children. Methods: This prospective study was conducted in 42 children aged between one to 14 years scheduled for elective surgery under general endotracheal anaesthesia. Mechanical ventilation was initiated with a tidal volume of 10 ml/kg. ΔVpeak, dIVC and stroke volume index (SVI) were measured before and after volume expansion (VE) with 10 ml/kg of crystalloid using transthoracic echocardiography. Patients were considered to be responders (R) and non-responders (NR) when SVI increased to either ≥15{\%} or <15{\%} after VE. ΔVpeak and dIVC were analysed between R and NR. Results: The best cut-off value for ΔVpeak as defined by the receiver operator characteristics (ROC) curve analysis was 12.2{\%}, for which sensitivity, specificity, positive predictive value and negative predictive value were 100{\%}, 94{\%}, 96{\%} and 100{\%}, respectively, the area under the curve was 0.975. The best cut-off value for dIVC as defined by the ROC curve analysis was 23.5{\%}, for which sensitivity, specificity, positive predictive value and negative predictive value were 91{\%}, 89{\%}, 91{\%} and 89{\%}, respectively, the area under the curve was 0.95. Conclusion: ΔVpeak and dIVC are reliable indices of fluid responsiveness in children.",
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Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children. / Achar, Shreepathi Krishna; Sagar, Maddani Shanmukhappa; Shetty, Ranjan; Kini, Gurudas; Samanth, Jyothi; Nayak, Chaitra; Madhu, Vidya; Shetty, Thara.

In: Indian Journal of Anaesthesia, Vol. 60, No. 2, 01.02.2016, p. 121-126.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Respiratory variation in aortic flow peak velocity and inferior vena cava distensibility as indices of fluid responsiveness in anaesthetised and mechanically ventilated children

AU - Achar, Shreepathi Krishna

AU - Sagar, Maddani Shanmukhappa

AU - Shetty, Ranjan

AU - Kini, Gurudas

AU - Samanth, Jyothi

AU - Nayak, Chaitra

AU - Madhu, Vidya

AU - Shetty, Thara

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Background and Aims: Dynamic parameters such as the respiratory variation in aortic flow peak velocity (ΔVpeak) and inferior vena cava distensibility index (dIVC) are accurate indices of fluid responsiveness in adults. Little is known about their utility in children. We studied the ability of these indices to predict fluid responsiveness in anaesthetised and mechanically ventilated children. Methods: This prospective study was conducted in 42 children aged between one to 14 years scheduled for elective surgery under general endotracheal anaesthesia. Mechanical ventilation was initiated with a tidal volume of 10 ml/kg. ΔVpeak, dIVC and stroke volume index (SVI) were measured before and after volume expansion (VE) with 10 ml/kg of crystalloid using transthoracic echocardiography. Patients were considered to be responders (R) and non-responders (NR) when SVI increased to either ≥15% or <15% after VE. ΔVpeak and dIVC were analysed between R and NR. Results: The best cut-off value for ΔVpeak as defined by the receiver operator characteristics (ROC) curve analysis was 12.2%, for which sensitivity, specificity, positive predictive value and negative predictive value were 100%, 94%, 96% and 100%, respectively, the area under the curve was 0.975. The best cut-off value for dIVC as defined by the ROC curve analysis was 23.5%, for which sensitivity, specificity, positive predictive value and negative predictive value were 91%, 89%, 91% and 89%, respectively, the area under the curve was 0.95. Conclusion: ΔVpeak and dIVC are reliable indices of fluid responsiveness in children.

AB - Background and Aims: Dynamic parameters such as the respiratory variation in aortic flow peak velocity (ΔVpeak) and inferior vena cava distensibility index (dIVC) are accurate indices of fluid responsiveness in adults. Little is known about their utility in children. We studied the ability of these indices to predict fluid responsiveness in anaesthetised and mechanically ventilated children. Methods: This prospective study was conducted in 42 children aged between one to 14 years scheduled for elective surgery under general endotracheal anaesthesia. Mechanical ventilation was initiated with a tidal volume of 10 ml/kg. ΔVpeak, dIVC and stroke volume index (SVI) were measured before and after volume expansion (VE) with 10 ml/kg of crystalloid using transthoracic echocardiography. Patients were considered to be responders (R) and non-responders (NR) when SVI increased to either ≥15% or <15% after VE. ΔVpeak and dIVC were analysed between R and NR. Results: The best cut-off value for ΔVpeak as defined by the receiver operator characteristics (ROC) curve analysis was 12.2%, for which sensitivity, specificity, positive predictive value and negative predictive value were 100%, 94%, 96% and 100%, respectively, the area under the curve was 0.975. The best cut-off value for dIVC as defined by the ROC curve analysis was 23.5%, for which sensitivity, specificity, positive predictive value and negative predictive value were 91%, 89%, 91% and 89%, respectively, the area under the curve was 0.95. Conclusion: ΔVpeak and dIVC are reliable indices of fluid responsiveness in children.

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