AUTHOR=Xiong Zihong , Zhang Guoying , Zhou Qin , Lu Bing , Zheng Xuemei , Wu Mengjun , Qu Yi 

TITLE=Predictive Value of the Respiratory Variation in Inferior Vena Cava Diameter for Ventilated Children With Septic Shock

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.895651

DOI=10.3389/fped.2022.895651

ISSN=2296-2360

ABSTRACT=<sec><title>Objectives</title><p>This study aimed to investigate the predictive utility of respiratory variations of inferior vena cava diameters on fluid responsiveness in children with septic shock.</p></sec><sec><title>Design</title><p>A prospective observational single-center study.</p></sec><sec><title>Setting</title><p>A pediatric intensive care unit in a tertiary hospital in China.</p></sec><sec><title>Participants</title><p>Patients with sepsis shock who require invasive mechanical ventilation were recruited between 1 December 2017 and 1 November 2021.</p></sec><sec><title>Interventions and Measurements</title><p>Volume expansion (VE) was induced by a 30-min infusion of 20 ml/kg of normal saline. Hemodynamics indexes were obtained through bedside transthoracic echocardiography (TTE) measurement and calculation.</p></sec><sec><title>Results</title><p>A total of 86 patients were enrolled in this study, among them, 45 patients (52.3%) were considered to be non-responders (NR), with an increase in stroke volume variation (SVV) &lt;15% after VE. Multivariate logistic analysis showed that ΔIVC (adjusted OR = 1.615, 95% CI 1.092–2.215, <italic>p</italic> = 0.012) was the significant predictor associated with the fluid responsiveness. The area under the ROC of ΔIVC was 0.922 (95% CI: 0.829–1.000, <italic>p</italic> &lt; 0.01), and the cutoff value of ΔIVC used to predict fluid responsiveness was 28.5%, with a sensitivity and specificity of 95.4 and 68.5%, respectively.</p></sec><sec><title>Conclusions</title><p>The ΔIVC was found to have a potential value in predicting fluid responsiveness in mechanically ventilated children with septic shock.</p></sec>