Editorial Views  |   May 2019
Can the Brain Predict Fluid Responsiveness?
Author Notes
  • From the Department of Emergency Medicine, The Royal Children’s Hospital, Parkville, Victoria; the Murdoch Children’s Research Institute, Parkville; the Department of Pediatrics, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia (E.L.); and the Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, Virginia (P.E.M.).
  • This editorial accompanies the article on p. 719.
    This editorial accompanies the article on p. 719.×
  • Accepted for publication November 20, 2018.
    Accepted for publication November 20, 2018.×
  • Address correspondence to Dr. Long: elliot.long@rch.org.au
Article Information
Editorial Views / Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Pediatric Anesthesia / Respiratory System
Editorial Views   |   May 2019
Can the Brain Predict Fluid Responsiveness?
Anesthesiology 5 2019, Vol.130, 674-676. doi:10.1097/ALN.0000000000002587
Anesthesiology 5 2019, Vol.130, 674-676. doi:10.1097/ALN.0000000000002587
Resuscitation with IV fluid is a ubiquitous first-line form of acute circulatory support in emergency medicine, critical care, and anesthesiology. In this edition of Anesthesiology, Kim et al. examine the ability of transcranial ultrasound of the internal carotid artery peak velocity variability to predict fluid responsiveness in mechanically ventilated children after cardiac surgery.1  In a cohort of 30 postoperative cardiac infants, respiratory variation of the internal carotid artery blood flow peak velocity was measured using transfontanelle ultrasound, before and after the administration of 10 ml/kg saline. Stroke volume index was measured using transesophageal echocardiography to identify fluid responders (greater than 15% increase in stroke volume index). Before fluid loading, respiratory variation of the internal carotid artery velocity was 13 ± 3% in the fluid responders (n = 17) and 8 ± 3% in the nonresponders (n = 13). Transfontanelle respiratory variation in internal carotid artery blood flow peak velocity predicted an increase in stroke volume with an area under the receiver operating characteristics curve of 0.83 (95% CI, 0.65 to 0.94).