The purpose of this study is to validate Rainbow pleth variability index for prediction of fluid responsiveness in children.
Children undergoing surgery under general anesthesia will be enrolled. After anesthetic induction, they will be assessed via transthoracic echocardiography for measurement of the patient's stroke volume index (SVI). Also, pleth variability index and Rainbow pleth variability index will be measured under mechanical ventilation with tidal volume of 6, 8, 10 ml/kg. To exert fluid loading, 10ml/kg of crystalloid solution will be administered intravenously over 10 minutes. After fluid loading, the SVI will be measured again and fluid responsiveness will be determined according to increment ratio of the SVI. According to the determined fluid responsiveness, predictive power of pleth variability index and Rainbow pleth variability index for fluid responsiveness will be assessed by building a receiver-operating characteristics curve.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
45
Intravenous administration of 10ml/kg of crystalloids over 10 minutes
Transthoracic echocardiographic measurement of stroke volume index
Continuous measurement of pleth variability index and Rainbow pleth variability index
AUC of ROC curve
Area under the curve of the receiver-operating characteristics curve of pleth variability index and Rainbow pleth variability index for prediction of fluid responsiveness
Time frame: From start of anesthesia to end of anesthesia, Less than 24 hours
Appearance of abnormal heart rhythm
Electrocardiogram during the study for monitoring whether tachycardia, bradycardia, or arrhythmia appears. Heart rate will be compared between patients who were fluid responsive and who were not responsive.
Time frame: From start of anesthesia to end of study, Less than 24 hours
IBP
Invasive blood pressure during the study, including systolic, diastolic, mean blood pressure for monitoring whether hypertension or hypotension appears. Mean blood pressure will be compared between patients who were fluid responsive and who were not responsive.
Time frame: From start of anesthesia to end of study, Less than 24 hours
SpO2
Pulse oximetry during the study for monitoring whether hypoxia appears.
Time frame: From start of anesthesia to end of study, Less than 24 hours
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Changing tidal volume for mechanical ventilation as 6, 8, 10 ml/kg