Does stroke volume variation predict fluid responsiveness in children: A systematic review and meta-analysis

Area of Science:

• Pediatric Critical Care Medicine
• Cardiovascular Physiology
• Diagnostic Accuracy Studies

Background:

• Stroke volume variation (SVV) is a validated predictor of fluid responsiveness in adult patients.
• The utility of SVV in pediatric populations remains uncertain, necessitating further investigation.

Purpose of the Study:

• To systematically evaluate the diagnostic value of SVV in predicting fluid responsiveness in pediatric patients.
• To perform the first meta-analysis on the accuracy of SVV in children.

Main Methods:

• Systematic search of major databases (PubMed, EMBASE, Cochrane) up to December 2016.
• Inclusion of original studies assessing SVV's diagnostic accuracy in pediatric fluid responsiveness.
• Random-effects model for pooled sensitivity, specificity, diagnostic odds ratio, and AUC; QUADAS-2 for quality assessment.

Main Results:

• Six studies with 224 children and 279 fluid boluses were analyzed.
• Pooled sensitivity: 0.68, pooled specificity: 0.65, pooled DOR: 8.24, AUC: 0.81.
• Significant inter-study heterogeneity (I²=61.3%) was observed, attributed to small sample sizes and diverse study designs.

Conclusions:

• SVV demonstrates diagnostic value for predicting fluid responsiveness in mechanically ventilated children.
• High heterogeneity in existing data highlights the need for further high-quality studies to validate SVV's accuracy in pediatric patients.