Related Experiment Video
Updated: Feb 2, 2026
Calibrated Forceps Model of Spinal Cord Compression Injury
Published on: April 24, 2015
Diagnostic accuracy of a calibrated abdominal compression to predict fluid responsiveness in children
M Jacquet-Lagrèze1, N Tiberghien2, J-N Evain3
1Département d'Anesthésie Réanimation, Centre Hospitalier Louis Pradel, Bron, France; Université Claude-Bernard Lyon 1, Campus Lyon Santé Est, Lyon, France.
Insights
Calibrated abdominal compression accurately predicts fluid responsiveness in children with circulatory failure. This method, measuring stroke volume index variation (ΔSVi-CAC), offers a reliable alternative for hemodynamic resuscitation decisions.
Area of Science:
- Pediatric critical care medicine
- Hemodynamic monitoring
- Fluid resuscitation strategies
Background:
- Fluid administration is crucial for hemodynamic resuscitation to enhance stroke volume index (SVi).
- Accurate prediction of fluid responsiveness is essential for optimizing resuscitation in pediatric patients.
Purpose of the Study:
- To evaluate the accuracy of stroke volume index variation during calibrated abdominal compression (ΔSVi-CAC) in predicting fluid responsiveness in children.
- To compare ΔSVi-CAC with other methods like inferior vena cava (IVC) diameter variation.
Main Methods:
- Assessed pediatric patients (<8 years) with acute circulatory failure.
- Measured SVi at baseline, after abdominal compression (25 mm Hg), and after volume expansion (VE).
- Defined fluid responders as those with ≥15% increase in SVi after VE (ΔSVi-VE).
Main Results:
- ΔSVi-CAC strongly correlated with ΔSVi-VE (r=0.829, P<0.001).
- The area under the ROC curve for ΔSVi-CAC was 0.94, indicating high predictive accuracy.
- A ΔSVi-CAC threshold of 11% showed 95% specificity and 75% sensitivity for predicting fluid responsiveness.
Conclusions:
- ΔSVi-CAC is a reliable method for predicting fluid responsiveness in children with acute circulatory failure.
- This method is effective irrespective of the patient's ventilation status.
- ΔSVi-CAC demonstrates superior accuracy compared to IVC diameter variation for this purpose.
Background:
Fluid administration to increase stroke volume index (SVi) is a cornerstone of haemodynamic resuscitation. We assessed the accuracy of SVi variation during a calibrated abdominal compression manoeuvre (ΔSVi-CAC) to predict fluid responsiveness in children.
Methods:
Patients younger than 8 yr with acute circulatory failure, regardless of their ventilation status, were selected. SVi, calculated as the average of five velocity-time integrals multiplied by the left ventricular outflow tract surface area, was recorded at four different steps: baseline, after an abdominal compression with a calibrated pressure of 25 mm Hg, after return to baseline, and then after a volume expansion (VE) of 10 ml kg-1 lactated Ringer solution over 10 min. Patients were classified as responders if SVi variation after volume expansion (ΔSVi-VE) increased by at least 15%.
Results:
The 39 children included had a median [inter-quartile range (IQR)] age of 9 [5-31] months. Twenty patients were fluid responders and 19 were non-responders. ΔSVi-CAC correlated with ΔSVi-VE (r=0.829; P<0.001). The area under the receiver operating characteristic curve (ROCAUC) was 0.94 [95% confidence interval (CI), 0.85-0.99]. The best threshold for ΔSVi-CAC was 11% with a specificity of 95% [95% CI, 84-100] and a sensitivity of 75% [95% CI, 55-95]. ROCAUC of respiratory variation of IVC diameter (ΔIVC) was 0.53 [95% CI, 0.32-0.72].
Conclusion:
ΔSVi-CAC during abdominal compression was a reliable method to predict fluid responsiveness in children with acute circulatory failure regardless of their ventilation status.
Clinical Trials Registration:
CPP Lyon sud est II: n° ANSM 2015-A00388-41 Clinicaltrial.gov: NCT02505646.
Related Concept Videos
03:37Uncertainty in Measurement: Accuracy and Precision
01:27Density, Specific Weight, Specific Gravity and Compressibility of Fluid
Specific weight represents the weight per unit volume and is calculated by multiplying...
02:07Improving Translational Accuracy
01:11Glassware Calibration
Volumetric flasks: Volumetric flasks are designed to prepare aqueous solutions of precise volumes accurately with a calibration line on the neck. To calibrate a volumetric flask, it is important to fill it with distilled...
01:12Instrument Calibration
Analytical Balance Calibration
An analytical balance measures mass and requires regular calibration to...
02:27Predicting Molecular Geometry