Kurniawan Taufiq Kadafi, Takhta Khalasha, Sharfina Fulki Adilla Hidayat, Sarah Rafika Nursyirwan, Nielda Kezia Sumbung, Ardhanis Ramadhanti, Daendy Nova Setya, Dyahris Koentartiwi, Saptadi Yuliarto, Antonius H. Pudjiadi
Introduction: Shock, which, if not treated ade-quately, will increase the risk of mortality in chil-dren. Non-invasive hemodynamic monitoring is one of the keys to reducing child mortality due to shock. The Smith-Madigan inotropy index (SMII) has been tested as a tool for rapid and non-invasive estimation of myocardial contrac-tility measures. This study evaluated the correlations between arterial dP/dt measured by supra-systolic oscillometric central blood pressure (cBP) and SMII to identify the clinical utility of this non-invasive method as an alternative. Methods: This cross-sectional study was conducted among a healthy child population from four elementary schools in two provinces in In-donesia, aged 8-14 years. Individuals who met the inclusion criteria were performed on a phys-ical examination (weight and height) as well as cBP and arterial dP/dt max measurements using BP+ USCOM and SMII measurements using USCOM 1A simultaneously. Measurements using BP+ USCOM and USCOM 1A were performed simultaneously. Based on the previous study, left ventricle (LV) dP/dt = 1.25 (arterial dP/dt), so in this study, after obtaining arterial dP/dt data, the calculation of LV dP/dt was con-tinued, and then evaluated the correlations between 1.25 arterial dP/dt (LV dP/dt) and SMII. Results: Between August 2023 and January 2024, 283 children were enrolled as research subjects, with a median age of 11 years (ranging from 7 to 14 years). The cohort comprised 146 boys (51.6%) and 137 girls (48.4%). The median body weight recorded was 34.9 kg. The predominant nutritional status observed was classified as good nutrition (55.8%), while the prevalent height status among the subjects was categorized as normal height. In this study, a significant correlation was found between 1.25 arterial dP/dt (LV dP/dt) and SMII contractility parameters of ki-netic energy (KE) with r=0.34, 95% confidence interval (CI) 0.22-0.44, p<0.0001. Conclusion: This study obtained results indicating a significant relationship between arterial dP/dt max and SMII contractility parameters. The LV dP/dt max value, calculated from the measurement of arterial dP/dt max using a non-invasive method, can be used as an alternative to assess LV contractility. © 2025, The Indonesian Foundation of Critical Care Medicine. All rights reserved.
Department of Pediatrics, Medical Faculty, Universitas Brawijaya, Saiful Anwar General Hospital, Malang, Indonesia; Department of Pediatrics, Medical Faculty, Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
