Department of Paediatric Anaesthesiology and Intensive Care Medicine, Lund Children´s Hospital, Skåne University Hospital, Lund, Sweden.
Department of Anaesthesiology and Intensive Care Medicine, Landspitalinn University Hospital, Reykjavik, Iceland.
Acta Anaesthesiol Scand. 2021 Feb;65(2):195-202. doi: 10.1111/aas.13720. Epub 2020 Oct 30.
Haemodynamic studies in children are rare and most studies have included few subjects in the youngest age group. Haemodynamic variables need to be indexed to establish a reference of normality that is valid in all populations. The traditional way to index haemodynamic variables with body surface area (BSA) is complicated in young children due to its non-linear relationship with body weight (BW). We examined several haemodynamic variables in children by indexing them with BSA and BW.
A single-centre, observational cohort study comparing non-indexed and indexed haemodynamic variables in children undergoing heart surgery (divided into three weight groups: 1-5 kg, >5-10 kg and >10-15 kg).
A total of 68 children were included in this study, mean age 11.1 months ± 11.1 month (range 0 to 43 months). All haemodynamic variables, cardiac output (CO), stroke volume (SV), total end-diastolic volume (TEDV), central blood volume (CBV) and active circulation volume (ACV), increased with weight without indexing (P < .05). Indexing variables with BW produced a more linear relationship for all haemodynamic variables between weight groups than BSA. The mean BSA-indexed haemodynamic values were CI 3.5 ± 1.1 L/min/m and SVI 27.3 ± 8.9 ml/min/m . The mean BW-indexed haemodynamic values were CI 180 ± 50 ml/min/kg and SVI 1.34 ± 0.38 ml/kg. Blood volume variables indexed with BW were TEDV 12.0 ± 2.8 ml/kg, CBV 21.3 ± 6.6 ml/kg and ACV 70.3 ± 15.2 ml/kg.
Indexing haemodynamic variables with BW produces a more appropriate body size-independent scale in young children than BSA.
In this study, we studied indexing of haemodynamic variables and estimation of blood volumes in young children undergoing corrective heart surgery using an indicator dilution technology.
儿童的血流动力学研究很少，大多数研究都只纳入了年龄最小的一组的少数受试者。血流动力学变量需要进行指数化处理，以建立适用于所有人群的正常参考值。由于体重（BW）与体表面积（BSA）呈非线性关系，传统的用 BSA 指数化血流动力学变量的方法在幼儿中较为复杂。我们通过用 BSA 和 BW 指数化血流动力学变量，对接受心脏手术的儿童进行了多项血流动力学变量的检查。
这是一项单中心、观察性队列研究，比较了接受心脏手术的儿童中非指数化和指数化的血流动力学变量（分为三组体重：1-5kg、>5-10kg 和>10-15kg）。
本研究共纳入 68 例患儿，平均年龄 11.1 个月±11.1 个月（0-43 个月）。所有血流动力学变量，心输出量（CO）、每搏量（SV）、总舒张末期容积（TEDV）、中心血容量（CBV）和主动循环容积（ACV），在不进行指数化的情况下随体重增加而增加（P<.05）。用 BW 指数化变量，各血流动力学变量在体重组间的关系比 BSA 更具线性关系。BSA 指数化血流动力学值的平均值为 CI 3.5±1.1 L/min/m，SVI 27.3±8.9 ml/min/m。BW 指数化血流动力学值的平均值为 CI 180±50 ml/min/kg，SVI 1.34±0.38 ml/kg。用 BW 指数化的血容量变量为 TEDV 12.0±2.8 ml/kg、CBV 21.3±6.6 ml/kg 和 ACV 70.3±15.2 ml/kg。
用 BW 指数化血流动力学变量比 BSA 更能为幼儿提供更合适的、不依赖体型的指标。
在这项研究中，我们使用指示剂稀释技术研究了接受矫正性心脏手术的幼儿血流动力学变量的指数化和血容量估计。
