Pulse pressure variation demonstrates dose-dependent response to volume resuscitation in pediatric craniosynostosis repair

Background

Restoring intravascular volume in the face of hemorrhagic blood loss is a fundamental skill critical to the practice of anesthesiology. Predictors of fluid responsiveness in pediatric patients remain a challenge. Pulse pressure variation (PPV) is a valuable predictor of volume responsiveness in adults, but the utility in pediatric resuscitation remains controversial. Surgical correction of craniosynostosis occurs early in childhood and is commonly associated with significant, rapid blood loss intraoperatively. This study examines the relationship between blood product boluses with PPV and mean arterial pressure (MAP).