Relationship between global end-diastolic volume and cardiac output in critically ill infants and children

Corrado Cecchetti, Riccardo Lubrano, Sebastian Cristaldi, Francesca Stoppa, Maria Antonietta Barbieri, Marco Elli, Raffaele Masciangelo, Daniela Perrotta, Elisabetta Travasso, Claudia Raggi, Marco Marano, Nicola Pirozzi

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: The objective of this study was to investigate possible correlations between the preload index global end-diastolic volume (GEDV) and the indexes of cardiac function, cardiac index, and stroke volume index in critically ill pediatric patients. The aim was to evaluate whether GEDV may help in the decision-making process concerning volume loading. DESIGN: Prospective clinical study. SETTING: Pediatric intensive care unit of the Bambino Gesù Children's Research Hospital. PATIENTS: Seventy patients, 40 male and 30 female, mean age 62 ± 41 months (range 5-156 months), divided into six groups: group A, hemorrhagic shock, ten cases; group B, head injury, 21 cases; group C, septic shock, ten cases; group D, encephalitis, ten cases; group E, respiratory failure, nine cases; group F, cardiogenic shock, ten cases. INTERVENTIONS: All patients received volumetric hemodynamic monitoring following initial resuscitation and every 4 hrs thereafter or whenever a hemodynamic deterioration was suspected. During the cumulative in-hospital stay, a total 1,184 sets of measurements were done. MEASUREMENTS AND MAIN RESULTS: Findings are consistent with a statistically significant linear correlation of GEDV with cardiac index and stroke volume index in hemorrhagic shock (group A) (R = .647, p <.0001; R = .738, p <.0001) and cardiogenic shock (group F) (R = .645, p <.0001; R = .841, p <.0001). CONCLUSIONS: GEDV may potentially be a useful guide to treatment in preload-dependent conditions, such as hemorrhagic and cardiogenic shock. In the other groups where there is little relationship between preload and cardiac function indexes, the influence of non-preload-dependent mechanisms on cardiac output is certainly more significant.

Original languageEnglish
Pages (from-to)928-932
Number of pages5
JournalCritical Care Medicine
Volume36
Issue number3
DOIs
Publication statusPublished - Mar 2008

Keywords

  • Cardiac index
  • Children
  • Global end-diastolic volume
  • Infants
  • Stroke volume index
  • Thermodilution

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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