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14 Prediction of Fluid Responsiveness in Mechanically Ventilated Children Using Transoesophageal Doppler (TOD) and Transthoracic Echocardiography (TTE) in Algerian’s Picu
  1. K El Halimi,
  2. MA Negadi,
  3. H Bouguetof,
  4. D Boumendil,
  5. ZC Mentouri
  1. Pediatric Intensive Care Unit, Faculty of Medicine, Oran University, Oran, Algeria

Abstract

Background and aims Circulatory failure treatment needs to assess blood volume status, in order to detect a hypovolemia requiring blood volume expansion. In this way, new dynamic echocardiographic and TOD parameters have recently been proposed in mechanically ventilated children, using the heart lung interactions, such as respiratory changes of aortic blood flow velocity, and inferior vena cava diameter.

This study aimed to compare respiratory variation in transthoracic echo-derived aortic blood flow velocity DVpeak and DIVCD with DVpeak and Doppler corrected flow times obtained by TOD.

Methods A prospective and comparative study conducted in pediatric intensive care unit investigated 11 mechanically ventilated children using TTE and TOD for each patient had tachycardia, hypotension, oliguria, delayed capillary refilling or hemodynamic instability despite vasopressor drugs.

Results VE induced significant changes in TTE and TOD, the DVpeak ao in responders was higher than that in non-responders [23% (15–32.1) vs.10% (6–14) by TTE and, [21% (14–29) vs.12% (11–13) by TOD, whereas DVCID and FTc did not significantly differ between groups.

Conclusion In this study, ΔVpeak was the most appropriate variable to predict fluid responsiveness by TTE and TOD. DIVCD and FTc are of little value in ventilated children.

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