PURPOSE: Fluid overload is a risk factor for poor outcome in intensive care; thus volume loading should be tailored towards @entity1 who are likely to increase @entity64 volume. We aimed to evaluate the paediatric predictive ability ( @entity64 volume increase of at least 15  % after fluid bolus) of novel and established volumetric and dynamic haemodynamic variables, and assess the influence of baseline contractility on response. METHODS: We assessed 142 volume loading episodes (10  ml/kg crystalloid) in 100 critically ill ventilated @entity1 , median (interquartile) weight 10  (5.6-15)  kg. Eight advanced haemodynamic variables were assessed using two commercially available devices. Systemic ventricular contractility was measured as the maximum rate of systolic arterial pressure rise. RESULTS: Overall, predictive ability was poor, with volumetric variables performing better than dynamic (area under receiver operating characteristic curves ranged from 0.53 to 0.67). The best predictor was total end-diastolic volume index; however, this did not increase in a consistent way with volume loading, with change post volume being weakly related to baseline values (r  =  -0.19, p  =  0.02). A multivariable model quantified the importance of contractility in @entity64 volume response. @entity1 with high baseline contractility (>= 75th centile) typically achieved a positive @entity64 volume response when end-diastolic volume values changed by 10-15  ml/m(2.6), whereas @entity1 with low contractility ( <=25th centile) typically required end-diastolic volume increases of 35-40  ml/m(2.6). CONCLUSIONS: Current paediatric predictors of volume response perform poorly; prediction may be improved if baseline contractility is taken into account.

Predicting fluid responsiveness in 100 critically ill XXXX : the effect of baseline contractility.

@entity1 :: ('9606', 'Species') :: ['patients', 'children', 'Children'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke']
@entity1 :: (9606,Species) :: ['children']
