Relationship between global end-diastolic volume and cardiac output in critically ill infants and children

Objective: The objective of this study was to investigate possible correlations between the preload index global end-diastolic volume (GEDV) and the indexes of cardiac function, cardiac index, and stroke volume index in critically ill pediatric patients. The aim was to evaluate whether GEDV may help in the decision-making process concerning volume loading. Design: Prospective clinical study. Setting: Pediatric intensive care unit of the Bambino Gesu Children’s Research Hospital. Patients: Seventy patients, 40 males and 30 females, mean age 62 41 months (range 5–156 months), divided into six groups: group A, hemorrhagic shock, ten cases; group B, head injury, 21 cases; group C, septic shock, ten cases; group D, encephalitis, ten cases; group E, respiratory failure, nine cases; group F, cardiogenic shock, ten cases. Interventions: All patients received volumetric hemodynamic monitoring following initial resuscitation and every 4 hrs thereafter or whenever a hemodynamic deterioration was suspected. During the cumulative in hospital stay, a total 1,184 sets of measurements were done. Measurements and Main Results: Findings are consistent with a statistically significant linear correlation of GEDV with cardiac index and stroke volume index in hemorrhagic shock (group A) (R 2 .647, p < .0001; R 2 .738, p < .0001) and cardiogenic shock (group F) (R 2 .645, p < .0001; R 2 .841, p < .0001).