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TABLE 10.7
AGE-SPECIFIC VITAL SIGN TARGETS

Several non- or minimally invasive monitoring devices are available to further
assess volume status, cardiac output, and tissue perfusion. Bedside
echocardiography (commonly referred to as cardiac ultrasound in the hands of a
noncardiologist) to serially measure IVC diameter and collapsibility, aortic blood
flow peak velocity (ΔVpeak ), and right ventricular diameter has been associated
with overall volume status and can predict clinical responsiveness to subsequent
volume loading. Although cardiac ultrasound is increasingly available, results are
prone to individual provider variability. More objective devices are available that
use pulse contour analysis to calculate cardiac output based on the relationship
between blood pressure, stroke volume, arterial compliance, and SVR. However,
these devices require placement of an arterial catheter, which limits their use for
initial resuscitation. Other devices that measure bioimpedance, which is the
change in voltage of a current applied across the thorax, are available to estimate
cardiac output without an arterial catheter, though pediatric experience remains
limited. Cutaneous near-infrared spectroscopy (NIRS) measures venous-weighted
oxyhemoglobin saturation in an underlying tissue bed (e.g., renal, splanchnic,