Point‐of‐Care Ultrasound Assessment of the Inferior Vena Cava in Mechanically Ventilated Critically Ill Children. (20th February 2020)

• Record Type: Journal Article
• Authors: Basu, Sonali; Sharron, Matthew; Herrera, Nicole; Mize, Marisa; Cohen, Joanna
• Is Part Of: Journal of ultrasound in medicine. Volume 39:Number 8(2020)
• Page Start: 1573
• Page End: 1579
• Publication Date: 2020-02-20
• Subjects: fluid status -- inferior vena cava -- point‐of‐care ultrasound; Ultrasonics in medicine -- Periodicals; Ultrasonics; Ultrasonography; Ultrasonics in medicine; Electronic journals; Periodicals; Periodicals; 616.07543
• DOI: 10.1002/jum.15247
• Languages: English
• ISSNs: 0278-4297

Abstract

Abstract : Objectives: The objective of this study was to compare the ultrasound‐measured inferior vena cava distensibility index (IVCdi), inferior vena cava distensibility variability (IVCdv), and inferior vena cava–to–aorta ratio (IVC/Ao) to other common methods to assess fluid status in mechanically ventilated pediatric critically ill patients. These methods include central venous pressure (CVP), percent fluid overload by weight (%FOw), and percent fluid overload by volume (%FOv). Methods: This was a prospective observational study of a convenience sample of 50 mechanically ventilated pediatric patients. Ultrasound measurements of the inferior vena cava and aorta were obtained, and the IVCdi, IVCdv, and IVC/Ao were calculated and compared to CVP, %FOw, and %FOv. Results: The median %FOw was 5%, and the median %FOv was 10%. The mean CVP ± SD was 8.6 ± 4 mm Hg. The CVP had no significant correlation with %FOw or %FOv. There was no significant correlation of the IVCdi with CVP ( r = –0.145; P = .325) or %FOv ( r = 0.119; P = .420); however, the IVCdi had a significant correlation with %FOw ( P = .012). There was also no significant relationship of the IVCdv with CVP ( r = –0.135; P = .36) or %FOv ( r = 0.128; P = .385); however, there was a significant correlation between the IVCdv and %FOw ( P = .012). There was no relationship between the IVC/Ao and any other measures of fluid status. Conclusions: In this cohort of mechanically ventilated pediatric intensive care unit patients, many commonly used markers of fluid status showed weak correlations with each other. The IVCdi and IVCdv significantly correlated with %FOw and may have potential as markers for fluid overload in this patient population.