Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children

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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.

Original languageEnglish
Pages (from-to)1840-1844
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume34
Issue number9
DOIs
StatePublished - 1 Sep 2016

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Inferior Vena Cava
Dehydration
Aorta
Xiphoid Bone
ROC Curve
Transducers
Observational Studies
Hospital Emergency Service
Prospective Studies
Pediatrics
Sensitivity and Specificity

Cite this

@article{dfcfd230576c4e0e9398e2ce9de2d61f,
title = "Sonographic aorta/IVC cross-sectional area index for evaluation of dehydration in children",
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.",
author = "Hyuksool Kwon and Jung, {Jae Yun} and Lee, {Jin Hee} and Kwak, {Young Ho} and Kim, {Do Kyun} and Jung, {Jin Hee} and Chang, {Ik Wan} and Kyuseok Kim",
year = "2016",
month = "9",
day = "1",
doi = "10.1016/j.ajem.2016.06.060",
language = "English",
volume = "34",
pages = "1840--1844",
journal = "American Journal of Emergency Medicine",
issn = "0735-6757",
publisher = "W.B. Saunders Ltd",
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}

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

PY - 2016/9/1

Y1 - 2016/9/1

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 (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.

AB - 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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U2 - 10.1016/j.ajem.2016.06.060

DO - 10.1016/j.ajem.2016.06.060

M3 - Article

C2 - 27339224

AN - SCOPUS:84995400067

VL - 34

SP - 1840

EP - 1844

JO - American Journal of Emergency Medicine

JF - American Journal of Emergency Medicine

SN - 0735-6757

IS - 9

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