NONINVASIVE MONITORING OF CRITICALLY ILL CHILD

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HEMODYNAMIC MONITORING WITH ULTRASONOGRAPHY IN CRITICALLY ILL CHILD

Özden Özgür Horoz

Çukurova University, Faculty of Medicine, Department of Pediatrics, Adana, Türkiye

Özgür Horoz Ö. Hemodynamic Monitoring with Ultrasonography in Critically Ill Child. In: Bal A, editor. Noninvasive Monitoring of Critically Ill Child. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.31-41.

ABSTRACT

In parallel with the increase in the use of noninvasive devices in intensive care units and emergency departments all over the world, the use of bedside ultrasonography are gradually increasing. With bed- side ultrasonography, the patient’s volume status, fluid response, left ventricular systolic and diastolic function, right ventricular systolic and diastolic function, pneumothorax, pulmonary embolism and pericardial tamponade can be evaluated. To evaluate the volüme status and response to fluid, mea- surement of the diameter, the collapsibility index and, the distensibility index of the inferior vena cava are assessed. Bedside cardiac ultrasonography is most commonly used to evaluate the left ventricular function in intensive care units. Left ventricular function is usually determined by calculating or esti- mating the ejection fraction. In cases such as heart failure and hypovolemia, cardiac output and index measurements are made with the help of bedside ultrasonography to evaluate the ejection fraction/ stroke volume discordance, to better understand hemodynamics and to monitor quantitatively. Bedside ultrasonography has become an indispensable tool in the management of patients with unstable hemo- dynamics and in the evaluation of response to treatment.

Keywords: Ultrasonography; Child; Hemodynamics

Referanslar

  1. Aslan N, Yildizdas D, Horoz OO, Ekinci F, Turkish Pocus Study-Group. Point-of-care ultrasound use in pediatric intensive care units in Turkey. The Turkish journal of Pediatrics. 2020;62:770-7. [Crossref]  [PubMed]
  2. Musolino AM, Buonsenso D, Massolo AC, Gallo M, Supino MC, Boccuzzi E. Point of care ultrasound in the paediatric acute care setting: Getting to the 'heart' of respiratory distress. J Paediatr Child Health. 2021;57(3):318-322. [Crossref]  [PubMed]
  3. Mandeville jC, Colebourn CL. Can transthoracic echocardiography be used to predict fluid responsiveness in the critically ill patient? A systematic review. Crit Care Res Pract. 2012;2012:513480. [Crossref]  [PubMed]  [PMC]
  4. Horoz OO, Yildizdas D, Aslan N, Coban Y, Misirlioglu M, Haytoglu Z, Sertdemir Y, Gundeslioglu OO, Soyupak S. Sonographic measurements of Inferior Vena Cava, Aorta, anda IVC/aorta ratio in healthy children. Niger J Clin Pract. 2022 Jun;25(6):825-832. [Crossref]  [PubMed]
  5. Long E, Duke T, Oakley E, O'Brien A, Sheridan B, Babl FE, Pediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory variation of inferior vena cava diameter predict fluid re- sponsiveness in spontaneously ventilating children with sepsis. Emerg Med Australas. 2018;30(4):556-63. [Crossref]  [PubMed]
  6. Schmidt GA. POINT: should acute fluid resuscitation be guided primarily by inferior vena cava ultrasound for patients in shock? Yes. Chest. 2017;151:531-2. [Crossref]  [PubMed]
  7. Kory P. COUNTERPOINT: should acute fluid resuscitation be guided primarily by inferior vena cava ultrasound for patients in shock? No. Chest. 2017;151:533-6. [Crossref]  [PubMed]
  8. Ilyas A, Ishtiaq W, Assad S, Ghazanfar H, Mansoor S, Haris M, et al. Correlation of IVC diameter and collapsibility index with central venous pressure in the assessment of intravascular volume in critically ill patients. Cureus. 2017;9:e1025. [Crossref]  [PubMed]
  9. Basu S, Sharron M, Herrera N, Mize M, Cohen J. Pointof-Care Ultrasound Assessment of the Inferior Vena Cava in Mechanically Ventilated Critically Ill Children. journal of Ultrasound in Medicine. 2020;39(8):1573-9. [Crossref]  [PubMed]
  10. Bilgili B, Haliloglu M, Tugtepe H, Umuroglu T. The Assessment of Intravascular Volume with Inferior Vena Cava and Internal jugular Vein Distensibility Indexes in Children Undergoing Urologic Surgery. Journal of Investigative Surgery. 2018;31(6):523-8. [Crossref]  [PubMed]
  11. Zhang Z, Xu X, Ye S, Xu L. Ultrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis. Ultrasound in Medicine and Biology. 2014;40 (5):845-53. [Crossref]  [PubMed]
  12. Feissel M, Michard F, Faller jP, Teboul jL. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Intensive Care Medicine. 2004;30(9):1834-7. [Crossref]  [PubMed]
  13. Moretti R, Pizzi B. Inferior vena cava distensibility as a predictor of fluid responsiveness in patients with subarachnoid hemorrhage. Neurocritical Care. 2010;13(1):3-9. [Crossref]  [PubMed]
  14. Feissel M, Kalakhy R, Banwarth P, Badie j, Pavon A, Faller jP, et al. Plethysmographic variation index predicts fluid responsiveness in ventilated patients in the early phase of septic shock in the emergency department: a pilot study. Journal of Critical Care. 2013;28(5): 634-9. [Crossref]  [PubMed]
  15. Barbier C, Loubieres Y, Schmit C, Hayon j, Ricôme jL, jardin F, et al. Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients. Intensive Care Medicine. 2004;30(9):1740-6. [Crossref]  [PubMed]
  16. Bentzer P, Griesdale DE, Boyd j, MacLean K, Sirounis D, Ayas NT. Will this hemodynamically unstable patient respond to a bolus of intravenous fluids? journal of the American Medical Association. 2016;316(12):1298- 309. [Crossref]  [PubMed]
  17. Mackenzie DC, Noble VE. Assessing volume status and fluid responsiveness in the emergency department. Clin Exp Emerg Med. 2014;1(2):67-77. [Crossref]  [PubMed]  [PMC]
  18. Marik PE, Lemson j. Fluid responsiveness: An evolution of our understanding. Br j Anaesth. 2014;112(4):617-20. [Crossref]  [PubMed]
  19. Connors AF, Speroff T, Dawson NV, Thomas C, Harrell FE, Wagner D, et al. The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA. 1996;276 (11):889-97. [Crossref]  [PubMed]
  20. Marik PE, Cavallazzi R, Vasu T, Hirani A. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: A systematic review of the literature. Crit Care Med. 2009;37(9):2642-7. [Crossref]  [PubMed]
  21. Cannesson M, Le Manach Y, Hofer CK, Goarin jP, Lehot jj, Vallet B, et al. Assessing the diagnostic accuracy of pulse pressure variations for the prediction of fluid responsiveness: a "gray zone" approach. Anesthesiology. 2011;115(2):231-41. [Crossref]  [PubMed]
  22. Cattermole GN, Leung PY, Mak PS, Chan SS, Graham CA, Rainer TH. The normal ranges of cardiovascular parameters in children measured using the Ultrasonic Cardiac Output Monitor. Crit Care Med. 2010;38:1875. [Crossref]  [PubMed]
  23. Engle SJ, DiSessa TG, Perloff JK, Isabel-Jones J, Leighton J, Gross K, et al. Mitral valve E point to ventricular septal separation in infants and children. Am J Cardiol. 1983 Nov 1;52(8):1084-7. [Crossref]  [PubMed]
  24. Tissot C, Singh Y, Sekarski N. Echocardiographic evaluation of ventricular function for the neonatologist and pediatric intensivist. Front Pediatr. 2018;6:79. [Crossref]  [PubMed]  [PMC]
  25. Matos j, Kronzon I, Panagopoulos G, Perk G. Mitral annular plane systolic excursion as a surrogate for left ventricular ejection fraction. j Am Soc Echocardiogr. 2012;25(9):969-74. [Crossref]  [PubMed]
  26. Hu K, Liu D, Herrmann S, Niemann M, Gaudron PD, Voelker W, et al. Clinical implication of mitral annular plane systolic excursion for patients with cardiovascular disease. Eur Heart j Cardiovasc Imaging. 2013;14(3):205-12. [Crossref]  [PubMed]
  27. Koestenberger M, Ravekes W, Everett AD, Stueger HP, Heinzl B, Gamillscheg A, et al. Right ventricular function in infants, children and adolescents: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. j Am Soc Echocardiogr. 2009;22(6):715-9. [Crossref]  [PubMed]
  28. Keskin M, Kaya Ö, Yoldaş T, Karademir S, Örün UA, Özgür S, et al. Tricuspid annular plane systolic excursion and mitral annular plane systolic excursion cardiac reference values in 1300 healthy children: Single-center results. Echocardiography. 2020;37(8):1251-7. [Crossref]  [PubMed]
  29. Bouzat P, Walther G, Rupp T, Doucende G, Payen jF, Levy P, et al. Time course of asymptomatic interstitial pulmonary oedema at high altitude. Respir Physiol Neurobiol. 2013;186: 16-21. [Crossref]  [PubMed]
  30. Le Gal G, Righini M, Sanchez O, Roy PM, Baba-Ahmed M, Perrier A, et al. A positive compression ultrasonography of the lower limb veins is highly predictive of pulmonary embolism on computed tomography in suspected patients. Thromb Haemost. 2006;95: 963-6. [Crossref]  [PubMed]
  31. Kearon C, Ginsberg jS, Hirsh j. The role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Ann Intern Med. 1998;129:1044-9. [Crossref]  [PubMed]