Abstract
Objective
Current studies have not found sufficient evidence to encourage the use of ultrasound
for assessing dehydration in children. We introduce a new sonographic parameter, the
“aorta/inferior vena cava (IVC) cross-sectional area index” (Ao/IVCA) measured just
inferior to the xiphoid process, for the effective evaluation of dehydration in children.
Methods
This is a prospective, observational study. We enrolled children who presented to
the pediatric emergency department (PED) between May 2014 and January 2015. We measured
the maximum diameter of the aorta from inner wall to inner wall, and the long and
short axis diameters of IVC using a convex array transducer. Ao/IVCA was calculated
and compared with aorta/IVC maximal diameter index (Ao/IVCD) and the clinical dehydration
scale (CDS).
Results
A total of 34 children were enrolled. We found a statistically significant correlation
between Ao/IVCA and CDS (R2 = 0.30; P <.001). Ao/IVCD did not correlate significantly with CDS (R2 = 0.08; P =.11). The ability of Ao/IVCA and Ao/IVCD to predict CDS ≥1 was assessed using the receiver operating characteristic analysis. The area under
the receiver operating characteristic curve for Ao/IVCA was larger than that for Ao/IVCD
(0.87 vs 0.75, P= .04). The cut-off value of Ao/IVCA that yielded the maximum value of Youden index
was 1.81 (sensitivity: 72%, specificity: 89%).
Conclusions
Ao/IVCA might be a promising index for the assessment of dehydration. The diagnostic
performance of Ao/IVCA for dehydration might be higher than that of the method that
uses the maximum diameter of IVC and the aorta.
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Article Info
Publication History
Published online: June 14, 2016
Accepted:
June 13,
2016
Received in revised form:
June 13,
2016
Received:
May 27,
2016
Footnotes
☆Funding source: This study was supported, in part, by Seoul National University Bundang Hospital (Grant 14-2014-039).
☆☆Financial disclosure: All authors have nothing to disclose.
★Conflict of interest: All authors have no conflicts of interest to disclose.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
