Faculty of Medicine, Tanta University Hospital, Pediatric Department, El Geish street, Tanta, Egypt.
J Pediatr Gastroenterol Nutr. 2018 Jun;66(6):882-886. doi: 10.1097/MPG.0000000000001865.
The aim of the study was to assess the accuracy of the inferior vena cava to aorta (IVC/Ao) diameter ratio for predicting significant dehydration in infants relative to their percentage weight change and the clinical diagnosis by a physician.
A prospective observational study was performed on 200 infants presented with acute diarrhea and clinical evidence of significant dehydration whose treatment required intravenous (IV) fluids as determined by the attending physician at the pediatric emergency department of Tanta University Hospital. Weight was recorded at admission before IV fluid treatment and at hospital discharge. The percentage of dehydration was determined using the following formula: (discharge weight - admission weight)/discharge weight × 100%. Patients with a percentage weight change of <5% were considered to be nonsignificantly dehydrated, whereas patients with a percentage weight change >5% were considered significantly dehydrated. The IVC/Ao diameter ratio was measured for all patients before IV fluid rehydration and again at discharge.
Only 134 out of 200 dehydrated infants were found to be significantly dehydrated using the gold standard, percentage weight change. Receiver operating characteristics (ROC) curve analysis of the prehydration IVC/Ao ratio showed a sensitivity of 82%, a specificity of 91%, and an accuracy of 87% for predicting significant dehydration in infants at a cut-off point of less than 0.75. In contrast, physician clinical diagnosis showed a sensitivity of 70%, a specificity of 63%, and an accuracy of 73%.
The IVC/Ao diameter ratio can be used as a reliable predictor for diagnosing significant dehydration in infants.
本研究旨在评估下腔静脉与主动脉（IVC/Ao）直径比预测婴儿严重脱水的准确性，与体重变化百分比及医师临床诊断相比。
对 200 例因急性腹泻就诊且有明显脱水临床证据的婴儿进行前瞻性观察研究，其治疗需要静脉（IV）补液，由坦塔大学医院儿科急诊的主治医生决定。入院时在接受 IV 液治疗前和出院时记录体重。脱水程度采用以下公式计算：（出院体重-入院体重）/出院体重×100%。体重变化百分比<5%的患者被认为是非严重脱水，而体重变化百分比>5%的患者被认为是严重脱水。所有患者在接受 IV 液补液前和出院时均测量 IVC/Ao 直径比。
仅 200 例脱水婴儿中，134 例根据体重变化百分比的金标准被认为是严重脱水。预补液 IVC/Ao 比值的受试者工作特征（ROC）曲线分析显示，在截断值<0.75 时，预测婴儿严重脱水的敏感度为 82%，特异度为 91%，准确度为 87%。相比之下，医师临床诊断的敏感度为 70%，特异度为 63%，准确度为 73%。
IVC/Ao 直径比可作为诊断婴儿严重脱水的可靠预测指标。
