J Pediatr Intensive Care 2017; 06(03): 145-151
DOI: 10.1055/s-0036-1593388
Original Article
Georg Thieme Verlag KG Stuttgart · New York

A Survey of Pediatric Critical Care Providers on the Presence, Severity, and Assessment of Capillary Leak in Critically Ill Children

Richard Pierce
1   Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States
,
Peter M. Luckett
2   Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Edward Vincent S. Faustino
1   Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, United States
› Author Affiliations
Further Information

Publication History

04 July 2016

11 August 2016

Publication Date:
26 September 2016 (online)

Abstract

Purpose To determine provider opinions on factors most commonly used to assess the presence and severity of pathologic capillary leak in critically ill children.

Methods We conducted an electronic survey of pediatric critical care providers. Patient scenarios were presented to assess opinions on the risk, presence, and clinical significance of capillary leak. Responses were obtained using Likert scales and multiple-choice questions.

Results A total of 160 responses were analyzed. Respondents agreed that capillary leak is present in the scenario with septic shock while respondents somewhat agreed that it is also present with poly-trauma, cardiac arrest, or cardiopulmonary bypass. They agreed that physical exam, but neither agreed nor disagreed that laboratory tests, can be used to assess and follow the severity of capillary leak in these children. Generalized edema, increase in weight, and pulmonary crackles were commonly identified parameters for assessing capillary leak. The patient factor most commonly identified with capillary leak was presence of infection, while treatment factors most commonly identified were cardiopulmonary bypass and general anesthesia.

Conclusion There is agreement that capillary leak is common in critically ill children and exacerbates disease. The parameters identified in this study may facilitate a more standardized clinical evaluation of pathologic capillary leak for future studies.

 
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