Bedside Evaluation of Fluid Responsiveness in Shock State using Electrical Cardiometry

Background: The initial hemodynamic management for pediatric shocked patients is giving aggressive fluid resuscitation, however fluid overload increases mortality and morbidity, so assessment and monitoring of fluid status have greatest benefit for critical patients to keep hemodynamic stability. Electrical cardiometry is an accurate, easy, and safe method for hemodynamic measurement, and can be used to monitor fluid responsiveness in critically ill patients.

Objectives: To examine stroke volume variation (SVV), evaluated through electrical cardiometry as a predictor of fluid responsiveness in management of shock.

Patients & Method: This was a cohort study done by observation of 60 shocked pediatric patients who received fluid therapy in the Intensive care units at Cairo University Pediatric Hospitals from July till December 2018.

Results: On comparing between patients who were volume non-responders versus volume responders, SVV was highly significant as it was higher in non-responders (P<0.000), also it was higher in patients who died than those who were discharged (p =0.002), it can be used as predictor of mortality with sensitivity of 80%, specificity of 75%, it also can be used as predictor of volume responsiveness with sensitivity of 85%, specificity of 92%.

Conclusion: Monitoring SVV, using electrical cadiometery could guide fluid therapy in critically ill pediatric cases, with beneficial impacts on morbidities and mortalities.