Abstract

Background: Mechanical ventilation has negative effect on the hemodynamic (HD) status of patients, which require boluses intravenous fluid (IVF). So hemodynamic monitoring is indicated to help adjusting adequate fluid balance to maintain tissue perfusion.

Objective: To evaluate the hemodynamic parameters after fluid resuscitation in mechanically ventilated children.

Patients: 64 mechanically ventilated children in Pediatric Intensive Care Unit (PICU) received bolus IVF. They were divided in Group I as Responder and Group II as Non- responder to IVF.

Methods: Conventional monitoring including heart rate(HR), mean arterial blood pressure (MABP)and central venous pressure (CVP), Trans-esophageal measurement of Stroke Volume(SV), Cardiac Output (COP), Cardiac Index(CI), Systemic vascular resistance(SVR), Flow Time Corrected (FTc) and Systemic vascular resistance index(SVRI) before and 20 minutes after intravenous fluid bolus

Results: There was statistically non- significant difference in HR, MABP, CVP and Systemic Vascular Resistance SVR between group I compared with group II before and after IVS infusion also inside each group. SV, CI and FTc were significantly increased in group I after IVS infusion compared with before IVS infusion, also in group I compared with group II after IVS infusion. CVP, SV and SVRI had significant cutoff values to predict length of stay (LOS) > 7 days.

Conclusion: Trans-esophageal monitoring for cardiac function could show the changes in hemodynamics after intravenous fluids better than conventional monitoring. (Mainly in responders and to less instinct in non-responders).

Keywords

Ventilated Children; Trans-Esophageal

Introduction