•  
  •  
 

Abstract

Purpose: To assess the correlation of respiratory variation in IVC with CVP in children. Secondary objective was to evaluate IVC variability with clinical hydration status. Methods: IVC variability assessed at the subcostal (SC), and right lateral (RL) region and collapsibility index (CI) (spontaneously breathing) and distensibility index (DI) (positive pressure) and IVC/Aortic ratio calculated. Partial correlations calculated between CI/DI with CVP adjusting for BMI & age. Sensitivity of CI & DI to predict clinical dehydration calculated using ROC curves. Results: 145 ultrasounds on 72 patients (41% positive pressure). Only RL CI in spontaneously breathing patients strongly correlated with CVP (r =-0.65, p < 0.001). A moderate correlation was observed between CI and DI from SC and RL regions (rs = 0.38 & 0.47). Among spontaneously breathing patients, a significant difference was observed in the SC CI based on hydration status. For patients on positive pressure, IVC/aortic ratio had a significant difference. SC CI had the highest AUC (0.82) to detect dehydration with 80% sensitivity/ 87% specificity for a cut-off of 40%. Conclusions: SC CI is the most reliable measure to assess the hydration status of spontaneously breathing children, while the IVC/aortic ratio performs well for patients under positive pressure. RL CI has strong negative correlation with CVP in spontaneously breathing patients.

Download

Share

COinS