Journal Article

Recommendations for hemodynamic monitoring for critically ill children—expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Saxena, Rohit, Tibby, Shane M., de Boode, Willem, Villaescusa, Javier Urbano, Bottari, Gabriella, Herce, Jesus Lopez, Di Nardo, Matteo, Cecchetti, Corrado, Singh, Yogen, da Cruz, Eduardo M., Brierley, Joe, Lemson, Joris, Guillén, Marga

2020

Overview

Background Cardiovascular instability is common in critically ill children. There is a scarcity of published high-quality studies to develop meaningful evidence-based hemodynamic monitoring guidelines and hence, with the exception of management of shock, currently there are no published guidelines for hemodynamic monitoring in children. The European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Cardiovascular Dynamics section aimed to provide expert consensus recommendations on hemodynamic monitoring in critically ill children. Methods Creation of a panel of experts in cardiovascular hemodynamic assessment and hemodynamic monitoring and review of relevant literature—a literature search was performed, and recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. The AGREE statement was followed to prepare this document. Results Of 100 suggested recommendations across 12 subgroups concerning hemodynamic monitoring in critically ill children, 72 reached “strong agreement,” 20 “weak agreement,” and 2 had “no agreement.” Six statements were considered as redundant after rephrasing of statements following the first round of voting. The agreed 72 recommendations were then coalesced into 36 detailing four key areas of hemodynamic monitoring in the main manuscript. Due to a lack of published evidence to develop evidence-based guidelines, most of the recommendations are based upon expert consensus. Conclusions These expert consensus-based recommendations may be used to guide clinical practice for hemodynamic monitoring in critically ill children, and they may serve as a basis for highlighting gaps in the knowledge base to guide further research in hemodynamic monitoring.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Associations / Best practice / Blood pressure / Body fluids / Cardiovascular instability / Catheters / Children / Consensus / Critical care / Critical Care Medicine / Critical Illness - therapy / Emergency Medicine / Hemodynamic monitoring (HD) / Hemodynamic Monitoring - methods / Hemodynamic Monitoring - trends / Hemodynamics / Humans / Infant / Infant, Newborn / Intensive / Intensive care / Medicine / Medicine & Public Health / Neonatal care / Neonatal intensive care / Newborn babies / Newborn infants / Oxygen saturation / Paediatric intensive care unit (PICU) / Patient monitoring equipment / Pediatrics / Pediatrics - methods / Pediatrics - trends / Pulmonary arteries / Recommendations / Sepsis / Shock / Spectrum analysis / Ultrasonic imaging / Working groups