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Fluid responsiveness in the pediatric population

대한마취과학회지 2019년 72권 5호 p.429 ~ 440
 ( Lee Ji-Hyun ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine

 ( Kim Eun-Hee ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine
 ( Jang Young-Eun ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine
 ( Kim Hee-Soo ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine
 ( Kim Jin-Tae ) - Seoul National University College of Medicine Seoul National University Hospital Department of Anesthesiology and Pain Medicine

Abstract


It is challenging to predict fluid responsiveness, that is, whether the cardiac index or stroke volume index would be increased by fluid administration, in the pediatric population. Previous studies on fluid responsiveness have assessed several variables derived from pressure wave measurements, plethysmography (pulse oximeter plethysmograph amplitude variation), ultrasonography, bioreactance data, and various combined methods. However, only the respiratory variation of aortic blood flow peak velocity has consistently shown a predictive ability in pediatric patients. For the prediction of fluid responsiveness in children, flow- or volume-dependent, noninvasive variables are more promising than pressure-dependent, invasive variables. This article reviews various potential variables for the prediction of fluid responsiveness in the pediatric population. Differences in anatomic and physiologic characteristics between the pediatric and adult populations are covered. In addition, some important considerations are discussed for future studies on fluid responsiveness in the pediatric population.

키워드

Blood pressure; Cardiac output; Children; Doppler ultrasonography; Fluid therapy; Hemodynamic monitoring; Oximetry; Pulse wave analysis
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