The investigators aim to validate markers of metabolic fluid-responsiveness in children with acute circulatory failure following cardiac surgery. This would allow physicians to identify which patient could benefit the most from fluid expansion, thus avoiding useless and potentially dangerous fluid expansions that could lead to fluid overload. To this end, The investigators will evaluate the diagnostic accuracy of the ratio of central venous to arterial carbon dioxide tension (Pv-aCO2) to arteriovenous oxygen content (CavO2), a simple biological marker of anaerobic metabolism, for the diagnosis of metabolic fluid responsiveness defined as a significant increase in oxygen consumption (VO2) after fluid expansion.
Eligibility
Sex
ALL
Min age
0 Days
Max age
15 Years
Healthy volunteers
No
Inclusion Criteria:
* Age less than or equal to 15 years old
* Hospitalization in a pediatric intensive care unit after cardiac surgery
* Prescription by the attending physician of a fluid expansion of 10ml/kg
* Prescription of arterial and venous blood gas before and after the volume expansion to help manage acute circulatory failure
* Patient implanted with a functioning arterial line
* Patient implanted with a functioning central venous line in the superior vena cava territory
Exclusion Criteria:
* Patient less than 37 weeks' corrected gestational age
* Hemodynamic instability making the delay necessary for any test dangerous
* Supine position contraindicated or deleterious
* Impairment of echocardiographic acoustic window or restless patient making ultrasonography impossible
* Opposition to participate expressed by the patient or by a parent or legal guardian
Primary outcome measure(s)
Area under the ROC curve (AUROC, %) of baseline Pv-aCO2/DAVO2 ratio to diagnose metabolic fluid — at baseline The primary outcome measure of a diagnostic accuracy study is the discriminative ability of an index test (expressed as an area under the ROC curve) to diagnose a condition (defined by a positive gold-standard reference test). In this study:
* The index test is the baseline Pv-aCO2/DAVO2 ratio, i.e. the ratio between the veno-arterial carbon dioxide partial pressure gradient (mmHg) and the difference between arterial and venous oxygen content (ml.dl-1). Oxygen content and carbon dioxide partial pressure are measured by arterial and central venous blood gas analysis.
* The condition is "metabolic fluid responsiveness"
* The gold-standard reference test to diagnose metabolic fluid responsiveness is a VO2 increase of at least 15% between baseline and after volume expansion (i.e. ((VO2 after volume expansion - VO2 at baseline) / VO2 at baseline) \> 15%). VO2 (ml/min/m2) will be measured as follow: VO2=(10.CO.DAVO2)/(Body Surface Area), where CO (ml.min-1) is the cardiac output, measured b
Trial sites (8)
Facility
City
Region
Status
Hôpital Louis Pradel - Hospices Civils de Lyon
Bron
France
Recruiting
Hôpital Jeanne de Flandre - CHU de Lille
Lille
France
Recruiting
Hôpital de la Timone - Assistance Publique - Hôpitaux de Marseille
Marseille
France
Not Yet Recruiting
Hôpital mère-enfant - CHU de Nantes
Nantes
France
Recruiting
Hôpital Necker-Enfants Malades - Assistance Publique - Hôpitaux de Paris
Paris
France
Recruiting
Hôpital Cardiologique Haut Lévêque - CHU de Bordeaux
Pessac
France
Recruiting
Hôpital des enfants - CHU de Toulouse
Toulouse
France
Not Yet Recruiting
Hôpital Felix Guyon - CHU de la Réunion
Saint-Denis
La Réunion
Recruiting
More University Hospital, Bordeaux trials in France
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
We use cookies to analyse site traffic and improve your experience. With your consent, we may also use cookies for advertising. You can change your choice at any time.
