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Assessment of left-ventricular diastolic function in pediatric intensive-care patients:a review of parameters and indications compared with those for adults

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World Journal of Pediatrics 2021年第1期17卷 21-30页

作者： Morgan Recher astrid botte Jerome Soquet Jean-Benoit Baudelet François Godart Stephane Leteurtre ULR 2694-METRICS:évaluation des Technologies de santéet des Pratiques Médicales Univ.LilleCHU Lille59000 LilleFrance Réanimation et Surveillance Continue Pédiatriques Hopital Jeanne de FlandreCHU de Lille59037 Lille CedexFrance Pediatric and Neonatal Intensive Care Unit CHU Bordeaux33076 BordeauxFrance Cardiac Surgery Unit CHU Lille59000 LilleFrance Congenital and Pediatric Cardiology Unit CHU Lille59000 LilleFrance

Background The incidence of diastolic heart failure has increased over *** evaluation of left-ventricular diastolic func-tion is complex,ongoing,and remains poorly performed in pediatric intensive-care *** study aimed to review the literature and to provide an update on the evaluation of left-ventricular diastolic function in adults and children in intensive *** sources We searched data from PubMed/***-two studies were *** pragmatic questions were identified:(1)What is the physiopathology of diastolic dysfunction?(2)Which tools are required to evaluate diastolic func-tion?(3)What are the echocardiographic criteria needed to evaluate diastolic function?(4)When should diastolic function be evaluated in pediatric intensive care?Results Early diastole allows characterization of relaxation,whereas compliance assessments and filling pressures are evalu-ated during late *** evolution of diastolic function differs between adults and *** in adults,decreased compliance occurs at the same time as delayed relaxation in *** function can be evaluated by Doppler *** echocardiographic criteria for ventricular relaxation include the E wave,E/A wave ratio,and isovolumic relaxation *** compliance can be assessed by the E/e'wave ratio,atrial volume,and Ap wave duration during pulmonary vein *** adult intensive-care patients,the E/e'ratio can be used as an index of tolerance for volume expan-sion in septic patients and to adjust the inotropic *** Clinical studies would allow some of these parameters to be validated for use in children in intensive care.

关键词： Diastole Echocardiography Heart failure Intensive-care unit Pediatric

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