Predictive Value of the Respiratory Variation in Inferior Vena Cava Diameter for Ventilated Children With Septic Shock

OBJECTIVES: This study aimed to investigate the predictive utility of respiratory variations of inferior vena cava diameters on fluid responsiveness in children with septic shock. DESIGN: A prospective observational single-center study. SETTING: A pediatric intensive care unit in a tertiary hospital in China. PARTICIPANTS: Patients with sepsis shock who require invasive mechanical ventilation were recruited between 1 December 2017 and 1 November 2021. INTERVENTIONS AND MEASUREMENTS: Volume expansion (VE) was induced by a 30-min infusion of 20 ml/kg of normal saline. Hemodynamics indexes were obtained through bedside transthoracic echocardiography (TTE) measurement and calculation. RESULTS: A total of 86 patients were enrolled in this study, among them, 45 patients (52.3%) were considered to be non-responders (NR), with an increase in stroke volume variation (SVV) <15% after VE. Multivariate logistic analysis showed that ΔIVC (adjusted OR = 1.615, 95% CI 1.092–2.215, p = 0.012) was the significant predictor associated with the fluid responsiveness. The area under the ROC of ΔIVC was 0.922 (95% CI: 0.829–1.000, p < 0.01), and the cutoff value of ΔIVC used to predict fluid responsiveness was 28.5%, with a sensitivity and specificity of 95.4 and 68.5%, respectively. CONCLUSIONS: The ΔIVC was found to have a potential value in predicting fluid responsiveness in mechanically ventilated children with septic shock.