Adewumi A A, Braimoh K T, M Adesiyun O A, Ololu-Zubair H T, Idowu B M
Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
Department of Radiology, Union Diagnostics and Clinical Services, Yaba, Lagos State, Nigeria.
Niger J Clin Pract. 2019 Jul;22(7):950-956. doi: 10.4103/njcp.njcp_591_18.
Accurate assessment of the degree of dehydration is essential in the management and fluid therapy of dehydrated children. The invasiveness of central venous pressure limits its routine clinical use. Fortunately, some studies have suggested that ultrasonographic measurement of inferior vena cava (IVC) diameter: aorta diameter ratio (IADR) is an objective method of assessing intravascular volume.
To determine the clinical usefulness of ultrasound measurement of IADR in assessment of children with dehydration.
This was a cross-sectional study which compared dehydrated children to age- and sex-matched euvolemic healthy children as controls. The maximum anteroposterior diameter of the abdominal aorta (at peak systole) and maximum IVC diameter (in expiration) were measured.
A total of 120 subjects and 120 controls were evaluated. The mean age was 21.73 ± 20.89 months for subjects and 21.19 ± 22.13 months for control. The mean IADR for children with mild, moderate, and severe dehydration was 0.75 ± 0.07, 0.55 ± 0.07, and 0.33 ± 0.05, respectively. The mean IADR for controls was 0.99 ± 0.06. IADR had an inverse relationship with the degree of dehydration in the subjects. A cut-off point of 0.86, with a sensitivity and specificity of 96.7% in predicting dehydration, was derived, with the sensitivity and specificity increasing with increasing level of dehydration.
IADR is sensitive and specific for assessing moderate and severe dehydration in Nigerian children.
准确评估脱水程度对于脱水儿童的管理和液体治疗至关重要。中心静脉压的侵入性限制了其在临床常规使用。幸运的是，一些研究表明，超声测量下腔静脉（IVC）直径与主动脉直径之比（IADR）是评估血管内容量的一种客观方法。
确定超声测量IADR在评估脱水儿童中的临床实用性。
这是一项横断面研究，将脱水儿童与年龄和性别匹配的血容量正常的健康儿童作为对照进行比较。测量腹主动脉的最大前后径（在收缩期峰值）和IVC的最大直径（在呼气时）。
共评估了120名受试者和120名对照。受试者的平均年龄为21.73±20.89个月，对照的平均年龄为21.19±22.13个月。轻度、中度和重度脱水儿童的平均IADR分别为0.75±0.07、0.55±0.07和0.33±0.05。对照的平均IADR为0.99±0.06。IADR与受试者的脱水程度呈负相关。得出预测脱水的截断点为0.86，敏感性和特异性为96.7%，且随着脱水程度的增加，敏感性和特异性也增加。
IADR在评估尼日利亚儿童中度和重度脱水方面具有敏感性和特异性。
