Determining pediatric fluid responsiveness by stroke volume variation analysis using ICON® electrical cardiometry and ultrasonic cardiac output monitor: A cross-sectional study

Kurniawan Taufiq Kadafi, Abdul Latief, Antonius Hocky Pudjiadi, Kurniawan Taufiq Kadafi, Abdul Latief, Antonius Hocky Pudjiadi

Abstract

Purpose: The purpose is to determine the adequacy fluid responsiveness by the validity and cut off point of stroke volume variation (SVV) usingelectrical cardiometry, ICON® (Osypka Medical, Berlin, Germany) and ultrasonic cardiac output monitor (USCOM) and to recognize cut off point of tidal volume in shock children with mechanical ventilation.

Materials and methods: A cross-sectional study was conducted from March 2017 to September 2017 in a single center. The selection of subject through consecutive sampling. Measurements of SVV and stroke volume (SV) using USCOM and ICON were performed before and after fluid challenge. The tidal volume of individuals was measured and recorded.

Results: Analysis was performed in 45 patients with median age of 14 months and 62.2% of male population. It showed that the sensitivity and specificity of ICON were 58% and 74%, respectively. The optimal cut off point of SVV using ICON was 16.5% and the area under the curve (AUC) value was 53% (95% confidence interval [CI] 35.9%-70%), P > 0.05 and cut off point of SVV using USCOM was 33.5% with the AUC value was 70% (95% CI 52.9%-87.7%), P < 0.05. The optimal cut off point of tidal volume to fluid responsivenes was 6.8 ml/kg BW and the AUC value was 44.6% (95% CI 27.4%-61.9%), P > 0.05.

Conclusion: This study showed that electrical cardiometry (ICON) is unable to assess preload and the response of fluid resuscitation in children.

Keywords: ICON; stroke volume variation; ultrasonic cardiac output monitor.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2020 International Journal of Critical Illness and Injury Science.

Figures

Figure 1
Figure 1
Receiver operator curve of stroke volume variation before fluid challenge as measured by ICON
Figure 2
Figure 2
Receiver operator curve of stroke volume variation before fluid challenge as measured by ultrasonic cardiac output monitor
Figure 3
Figure 3
Receiver operator curve of tidal volume (response to fluid administration) as measured by ultrasonic cardiac output monitor

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