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Seham Awad Elsherbiny Ali Bassant Salah Saad Meligy Ahmed Said Mohammed Behairy Mohamed Salah Mohamed Eldoadoa

Abstract

Background: The main goal of hemodynamic resuscitation is to achieve adequate tissue perfusion. This is initially attempted with intravascular volume expansion (VE). Although central venous pressure (CVP) role in prediction of fluid responsiveness is controversial, it remains the most commonly used parameter for detecting volume status in ICU patients. Methods: Forty-eight critically ill mechanically ventilated children considered for VE by clinical evaluation of circulatory status were prospectively included. Patients were divided in 2 age groups; group A:<24 months and group B: ≥24 months. Patients with Stroke volume variation (SVV) more than 10% after VE were categorized as volume responders. CVP values were noted before and after VE in the responder and non-responder groups. Results: For group A (<24 m); CVP had no statistical value in prediction of fluid responsiveness (p=0.083), however; in the total study population, and in group B (≥24m) it had value (p=0.001) in predicting responders with a sensitivity, specificity and cut off values of 88%,64% and ≤ 10 respectively in the total study population and 100%,88% and ≤11 respectively in group B. Also, both had good correlation with SVV that was better with group B (r=-0.778) than with total population (r=-0.454). Conclusion: CVP role in prediction of fluid responsiveness is un reliable in infant and young children (<24m), while in older children it is valuable in guiding fluid therapy together with the other dynamic variables.

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Keywords

: central venous pressure, CVP, fluid responsiveness, stroke volume variation (SVV)

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