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Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children.
Am J Emerg Med. 2016 Sep; 34(9):1840-4.AJ

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 (R(2) = 0.30; P <.001). Ao/IVCD did not correlate significantly with CDS (R(2) = 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.

Authors+Show Affiliations

Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Kangwon National University College of Medicine, Chuncheon, Gangwon-do, Republic of Korea. Electronic address: gienee74@gmail.com.Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Department of Emergency Medicine, Seoul National University Boramae Hospital, Seoul, Republic of Korea.Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

27339224

Citation

Kwon, Hyuksool, et al. "Sonographic aorta/IVC Cross-sectional Area Index for Evaluation of Dehydration in Children." The American Journal of Emergency Medicine, vol. 34, no. 9, 2016, pp. 1840-4.
Kwon H, Jung JY, Lee JH, et al. Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children. Am J Emerg Med. 2016;34(9):1840-4.
Kwon, H., Jung, J. Y., Lee, J. H., Kwak, Y. H., Kim, d. o. . K., Jung, J. H., Chang, I. W., & Kim, K. (2016). Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children. The American Journal of Emergency Medicine, 34(9), 1840-4. https://doi.org/10.1016/j.ajem.2016.06.060
Kwon H, et al. Sonographic aorta/IVC Cross-sectional Area Index for Evaluation of Dehydration in Children. Am J Emerg Med. 2016;34(9):1840-4. PubMed PMID: 27339224.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children. AU - Kwon,Hyuksool, AU - Jung,Jae Yun, AU - Lee,Jin Hee, AU - Kwak,Young Ho, AU - Kim,Do Kyun, AU - Jung,Jin Hee, AU - Chang,Ik Wan, AU - Kim,Kyuseok, Y1 - 2016/06/15/ PY - 2016/05/27/received PY - 2016/06/13/revised PY - 2016/06/13/accepted PY - 2016/6/25/entrez PY - 2016/6/25/pubmed PY - 2017/3/21/medline SP - 1840 EP - 4 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 34 IS - 9 N2 - 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 (R(2) = 0.30; P <.001). Ao/IVCD did not correlate significantly with CDS (R(2) = 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. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/27339224/Sonographic_aorta/IVC_cross_sectional_area_index_for_evaluation_of_dehydration_in_children_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(16)30276-5 DB - PRIME DP - Unbound Medicine ER -