[What non invasive haemodynamic assessment in paediatric intensive care unit in 2009?].

O. Brissaud, J. Guichoux, F. Villega, G. Orliaguet
Annales Françaises d'Anesthésie et de Réanimation. 2010-03-01; 29(3): 233-241
DOI: 10.1016/j.annfar.2009.12.022

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Comment in
Ann Fr Anesth Reanim. 2010 Oct;29(10):743-4.

The haemodynamic assessment of the patients is a daily activity in paediatric
intensive care unit. It completes and is guided by the clinical examination. The
will to develop the least invasive possible coverage of the patients is a
constant concern. The haemodynamic monitoring, all the more if it is invasive,
ceaselessly has to put in balance the profit and the risk of beginning this
technique at a fragile patient. In the last three decades, numerous non-invasive
haemodynamic tools were developed. The ideal one must be reliable, reproducible,
with a time of fast, easily useful answer, with a total harmlessness, cheap and
allowing a monitoring continues. Among all the existing tools (oesophageal
Doppler ultrasound method, transthoracic echocardiography, NICO, thoracic
impedancemetry, plethysmography, sublingual capnography), no one allies all these
qualities. We can consider that the transthoracic echocardiography gets closer to
most of these objectives. We shall blame it for its cost and for the fact that it
is an intermittent monitoring but both in the diagnosis and in the survey, it has
no equal among the non-invasive tools of haemodynamic assessment from part the
quality and the quantity of the obtained information. The learning of the basic
functions (contractility evaluation, cardiac output, cardiac and the vascular
filling) useful for the start of a treatment is relatively well-to-do. We shall
miss the absence of training in this tool in France in its paediatric and
neonatal specificity within the university or interuniversity framework.

Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.

DOI: 10.1016/j.annfar.2009.12.022
PMID: 20116968 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus