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Does bedside sonographic measurement of the inferior vena cava diameter correlate with central venous pressure in the assessment of intravascular volume in children?
Pediatr Emerg Care. 2013 Mar; 29(3):337-41.PE

Abstract

OBJECTIVES

Previous studies demonstrated that the collapsibility index (percent decrease in inferior vena cava [IVC] diameter with inspiration) of 50% or greater and an IVC/aorta ratio of 0.8 or less correlated with a low intravascular volume. Our study sought to determine if bedside ultrasound (BUS) measurements of the IVC diameter correlate with central venous pressure (CVP) measurements as an indicator of intravascular volume status in acutely ill children.

METHODS

A convenience sample of children younger than 21 years who were admitted to the pediatric critical care unit and required CVP monitoring had BUS measurements of both IVC and aortic diameters with simultaneous CVP measurement. The collapsibility index (sagittal view) and IVC/aorta ratio (transverse view) were calculated from these measurements. A CVP of 8 mm Hg or less was considered as a marker for decreased intravascular volume.

RESULTS

Of the 51 participants, 21 (43%) had a CVP of 8 mm Hg or less. Eight (16%) of 51 children had a collapsibility index 50% or greater, and 8 (18%) of 43 had an IVC/aorta ratio of 0.8 or less. The sensitivity of a collapsibility index 0.5 or greater to predict a CVP of 8 mm Hg or less was 14%, the specificity was 83%, the positive predictive value was 38%, and the negative predictive value was 57%. Neither collapsibility index (r = -0.23, P = 0.11) nor IVC/aorta (r = -0.19, P = 0.22) correlated with CVP in assessing intravascular volume in our study population.

CONCLUSIONS

Based on these data, the IVC and aortic measurements by BUS are not reliable indicators of intravascular volume (as determined by CVP) in acutely ill children.

Authors+Show Affiliations

Division of Emergency Medicine, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, NY 10467, USA. lorraine.ng@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23426248

Citation

Ng, Lorraine, et al. "Does Bedside Sonographic Measurement of the Inferior Vena Cava Diameter Correlate With Central Venous Pressure in the Assessment of Intravascular Volume in Children?" Pediatric Emergency Care, vol. 29, no. 3, 2013, pp. 337-41.
Ng L, Khine H, Taragin BH, et al. Does bedside sonographic measurement of the inferior vena cava diameter correlate with central venous pressure in the assessment of intravascular volume in children? Pediatr Emerg Care. 2013;29(3):337-41.
Ng, L., Khine, H., Taragin, B. H., Avner, J. R., Ushay, M., & Nunez, D. (2013). Does bedside sonographic measurement of the inferior vena cava diameter correlate with central venous pressure in the assessment of intravascular volume in children? Pediatric Emergency Care, 29(3), 337-41. https://doi.org/10.1097/PEC.0b013e31828512a5
Ng L, et al. Does Bedside Sonographic Measurement of the Inferior Vena Cava Diameter Correlate With Central Venous Pressure in the Assessment of Intravascular Volume in Children. Pediatr Emerg Care. 2013;29(3):337-41. PubMed PMID: 23426248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does bedside sonographic measurement of the inferior vena cava diameter correlate with central venous pressure in the assessment of intravascular volume in children? AU - Ng,Lorraine, AU - Khine,Hnin, AU - Taragin,Benjamin H, AU - Avner,Jeffrey R, AU - Ushay,Michael, AU - Nunez,Denise, PY - 2013/2/22/entrez PY - 2013/2/22/pubmed PY - 2013/8/24/medline SP - 337 EP - 41 JF - Pediatric emergency care JO - Pediatr Emerg Care VL - 29 IS - 3 N2 - OBJECTIVES: Previous studies demonstrated that the collapsibility index (percent decrease in inferior vena cava [IVC] diameter with inspiration) of 50% or greater and an IVC/aorta ratio of 0.8 or less correlated with a low intravascular volume. Our study sought to determine if bedside ultrasound (BUS) measurements of the IVC diameter correlate with central venous pressure (CVP) measurements as an indicator of intravascular volume status in acutely ill children. METHODS: A convenience sample of children younger than 21 years who were admitted to the pediatric critical care unit and required CVP monitoring had BUS measurements of both IVC and aortic diameters with simultaneous CVP measurement. The collapsibility index (sagittal view) and IVC/aorta ratio (transverse view) were calculated from these measurements. A CVP of 8 mm Hg or less was considered as a marker for decreased intravascular volume. RESULTS: Of the 51 participants, 21 (43%) had a CVP of 8 mm Hg or less. Eight (16%) of 51 children had a collapsibility index 50% or greater, and 8 (18%) of 43 had an IVC/aorta ratio of 0.8 or less. The sensitivity of a collapsibility index 0.5 or greater to predict a CVP of 8 mm Hg or less was 14%, the specificity was 83%, the positive predictive value was 38%, and the negative predictive value was 57%. Neither collapsibility index (r = -0.23, P = 0.11) nor IVC/aorta (r = -0.19, P = 0.22) correlated with CVP in assessing intravascular volume in our study population. CONCLUSIONS: Based on these data, the IVC and aortic measurements by BUS are not reliable indicators of intravascular volume (as determined by CVP) in acutely ill children. SN - 1535-1815 UR - https://www.unboundmedicine.com/medline/citation/23426248/Does_bedside_sonographic_measurement_of_the_inferior_vena_cava_diameter_correlate_with_central_venous_pressure_in_the_assessment_of_intravascular_volume_in_children L2 - http://dx.doi.org/10.1097/PEC.0b013e31828512a5 DB - PRIME DP - Unbound Medicine ER -