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Meta-Analysis
. 2017 May 12;12(5):e0177590.
doi: 10.1371/journal.pone.0177590. eCollection 2017.

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

Ling Yi  1   2 , Zhongqiang Liu  2   3 , Lina Qiao  2   3 , Chaomin Wan  2   4 , Dezhi Mu  2   4
Affiliations
Meta-Analysis

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

Ling Yi et al. PLoS One. .

Abstract

Objective: Stroke volume variation (SVV) is a reliable predictor of fluid responsiveness in adult patients. However, the predictive value of SVV is uncertain in pediatric patients. We performed the first systematic meta-analysis to evaluate the diagnostic value of SVV in predicting fluid responsiveness in children.

Methods: PUBMED, EMBASE, and Cochrane Central Register of Controlled Trials were searched up to December 2016. Original studies assessing the diagnostic accuracy of SVV in predicting fluid responsiveness in children were considered to be eligible. A random-effects model was used to calculate pooled values of sensitivity, specificity and diagnostic odds ratio with 95% CI. The summary receiver operating characteristic curve was estimated and area under the curve was calculated. Quality of the studies was assessed with the QUADAS-2 tool.

Results: Six studies with a total of 279 fluid boluses in 224 children were included. The analysis demonstrated a pooled sensitivity of 0.68 (95% CI,0.59-0.76), pooled specificity of 0.65 (95% CI, 0.57-0.73), pooled diagnostic odds ratio of 8.24 (95% CI, 2.58-26.30), and the summary area under the summary receiver operating characteristic curve of 0.81. However, significant inter-study heterogeneity was found (p<0.05, I2 = 61.3%), likely due to small sample size and diverse study characteristics.

Conclusions: Current evidence suggests that SVV was of diagnostic value in predicting fluid responsiveness in children under mechanical ventilation. Given the high heterogeneity of published data, further studies are needed to confirm the diagnostic accuracy of SVV in predicting fluid responsiveness in pediatric patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of study selection and inclusion.
Fig 2
Fig 2. Sensitivity, specificity and diagnostic odds ratio of stroke volume variation in predicting fluid responsiveness in children assessed by forest plots.
The point estimates of sensitivity, specificity and diagnostic odds ratio for each study are shown as solid circles.
Fig 3
Fig 3. Summary receiver operating characteristic curve of stroke volume variation in predicting fluid responsiveness in children.
Solid circles represent each study included in the meta-analysis.
See this image and copyright information in PMC

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