Left ventricular end-diastolic volume index as a predictor of fluid responsiveness in children with shock

Objective: To identify the role of left ventricular end-diastolic volume index as a predictor of fluid responsiveness in children. Design: This was a diagnostic study in children with shock in the Emergency Room and Pediatric Intensive Care Unit of Cipto Mangunkusumo Hospital from June to November 2018. The left ventricular end-diastolic volume index measurements were performed using ultrasonic cardiac output monitor and compared to the increase in stroke volume of ≥15% after fluid challenge as fluid responsiveness criteria. Samples were categorized into fluid responsive and non-responsive. Results: Out of 40 subjects, 60 fluid challenge samples were obtained. There were 31 and 29 samples in the fluid responsive and non-responsive group, respectively. There was no significant difference in mean left ventricular end-diastolic volume index between the two groups (p=0.161). The area under the receiver operating characteristic (AUROC) of the left ventricular end-diastolic volume index was 40.9% with a cutoff value of 68.95 ml/m². The sensitivity and specificity were 45.16% and 44.83%, respectively. At the left ventricular end-diastolic volume index value of 81.10 ml/m², the specificity was 72.41% with 22.6% sensitivity. Conclusion: This study cannot justify the use of left ventricular end-diastolic volume index can act as a predictor of fluid responsiveness in children.