Department of Pediatric Intensive Care Unit, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, Cannaught Place, New Delhi, 110001, India.
Indian J Pediatr. 2017 Oct;84(10):757-762. doi: 10.1007/s12098-017-2433-y. Epub 2017 Sep 4.
To find a correlation between inferior vena cava (IVC) diameters, IVC compressibility index (CI) and central venous pressure (CVP).
Prospective observational study was done at pediatric intensive care unit (PICU) of Kalawati Saran Children's Hospital (KSCH). Fifty children aged 5-18 y, presenting with shock were enrolled for the study. IVC diameters, CI and relevant clinical data were noted at enrollment, 30 min, 1 h, 6 h, and 12 h. Central line was placed at the time of admission.
Of 50 children enrolled, 28 were boys, with a mean age of 11 y. More than 80% of cases were diagnosed as septic shock. Mean maximum and minimum IVC diameter of 8.3 ± 2 mm and 3.7 ± 1.7 mm, respectively CI 58.2 ± 7% and CVP of 5.4 ± 1.5 cm of HO was observed at admission. CVP and IVC diameters showed a serial improvement with treatment; CI showed a serial decrease with treatment. Heart rate (HR) and systolic blood pressure (SBP) also showed a serial improvement at 12 h (p < 0.05). CVP showed a positive correlation with IVC diameter (r +0.312; p < 0.05), and a negative correlation with CI (r -0.343; p < 0.05).
Effective fluid resuscitation improves IVC diameters with a decrease in CI. IVC diameter has a positive correlation to CVP and CI has a negative correlation to CVP.
探讨下腔静脉（IVC）直径、IVC 可压缩指数（CI）与中心静脉压（CVP）之间的相关性。
这是一项在卡拉瓦蒂·萨兰儿童医院（KSCH）儿科重症监护病房（PICU）进行的前瞻性观察性研究。共纳入 50 名年龄在 5-18 岁、有休克表现的患儿。在入组时、入组后 30min、1h、6h 和 12h 记录 IVC 直径、CI 及相关临床数据。入院时即放置中心静脉导管。
在入组的 50 名患儿中，28 名是男孩，平均年龄为 11 岁。超过 80%的病例被诊断为感染性休克。入院时 IVC 的最大和最小直径分别为 8.3±2mm 和 3.7±1.7mm，CI 为 58.2±7%，CVP 为 5.4±1.5cmHO。随着治疗的进行，CVP 和 IVC 直径逐渐改善，CI 逐渐降低。12h 时心率（HR）和收缩压（SBP）也逐渐改善（p<0.05）。CVP 与 IVC 直径呈正相关（r=0.312；p<0.05），与 CI 呈负相关（r=-0.343；p<0.05）。
有效的液体复苏可改善 IVC 直径，同时降低 CI。IVC 直径与 CVP 呈正相关，而 CI 与 CVP 呈负相关。
