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

Kwon, Hyuksool; Jung, Jae Yun; Lee, Jin Hee; Kwak, Young Ho; Kim, Do Kyun; Jung, Jin Hee; Chang, Ik Wan; Kim, Kyuseok

doi:10.1016/j.ajem.2016.06.060

Cited by 19 publications

(24 citation statements)

References 13 publications

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“…In human medicine, the IVC/Ao often is used to assess intravascular volume because it can be used in patients with various weights and body sizes . Therefore, comparing the diameter of the IVC with the diameter of the abdominal aorta corrects for patients of various age, size, and weight.…”

Section: Discussionmentioning

confidence: 99%

“…35 In human medicine, the IVC/Ao often is used to assess intravascular volume because it can be used in patients with various weights and body sizes. [36][37][38] Therefore, comparing the diameter of the IVC with the diameter of the abdominal aorta corrects for patients of various age, size, and weight. Two recent studies validated ultrasonographic assessment of CVC/Ao using the spleno-renal and hepatic views to estimate volemia in dogs.…”

Section: Reference Values For Echocardiographic Dimensions Related mentioning

confidence: 99%

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Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Darnis

Boysen

Merveille

et al. 2018

Veterinary Internal Medicne

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BackgroundClinical assessment of intravascular volume status is challenging. In humans, ultrasonographic assessment of the inferior vena cava diameter, directly or as a ratio to the aortic diameter is used to estimate intravascular volume status.ObjectivesTo ultrasonographically obtain reference values (RV) for caudal vena cava diameter (CVCD), area (CVCa) and aortic ratios using 3 views in awake healthy dogs.AnimalsOne hundred and twenty‐six healthy adult dogs from clients, students, faculty, or staff.MethodsProspective, multicenter, observational study. Two observer pairs evaluated CVCD by a longitudinal subxiphoid view (SV), a transverse 11th‐13th right hepatic intercostal view (HV), and a longitudinal right paralumbar view (PV). Inter‐rater agreements were estimated using concordance correlation coefficients (CCC). For body weight (BW)‐dependent variables, RVs were calculated using allometric scaling for variables with a CCC ≥ 0.7.ResultsThe CCC was ≤0.43 for the CVC/aorta ratio at the PV and ≤0.43 in both inspiration and expiration for CVC at the SV. The RVs using allometric scaling for CVCa at the HV for inspiration, expiration, and for CVCD at the PV were 6.16 × BW0.762, 7.24 × BW0.787, 2.79 × BW0.390, respectively.Conclusions and Clinical ImportanceThe CVCD, measured at the HV and PV in healthy awake dogs of various breeds has good inter‐rater agreement suggesting these sites are reliable in measuring CVCD. Established RVs for CVCD for these sites need further comparison to results obtained in hypovolemic and hypervolemic dogs to determine their usefulness to evaluate volume status in dogs.

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Section: Discussionmentioning

confidence: 99%

Section: Reference Values For Echocardiographic Dimensions Related mentioning

confidence: 99%

Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Darnis

Boysen

Merveille

et al. 2018

Veterinary Internal Medicne

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“…2,3,16 Ultrasound evaluation of the abdominal aorta and caudal vena cava ratio has been used in human medicine for evaluation of volume depletion or response to fluid therapy primarily in children. [17][18][19] Size variability due to different canine breeds has prompted establishment of normal values for ratios of the caudal vena cava to aorta. One recent study measured the caudal vena cava to aorta ratio in dogs with induced volume depletion.…”

mentioning

confidence: 99%

Aortic to caudal vena cava ratio measurements using abdominal ultrasound are increased in dogs with confirmed systemic hypertension

Holland

Hudson

Bao

et al. 2019

Vet Radiology Ultrasound

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Chronically sustained systemic hypertension in dogs can damage the kidneys, eye, brain, heart, and vessels. In human medicine, systemic hypertension has been implicated as the most common risk factor for aorta dilation, which can progress to an aneurysm. Abdominal ultrasound has been commonly used to monitor the size of the abdominal aorta in people with systemic hypertension. In this retrospective cross‐sectional abdominal ultrasound study, evaluation of the size of the abdominal aorta relative to the caudal vena cava was performed in 18 control dogs and 128 dogs with confirmed systemic hypertension. Preexisting conditions contributing to systemic hypertension in these dogs were renal disease, hyperadrenocorticism, diabetes mellitus, adrenal tumors, and previous administration of phenylpropanolamine or palladia. The abdominal aorta and caudal vena cava were assessed from longitudinal images cranial to the trifurcation with measurements made from outer border to outer border of the walls, being careful not to compress the caudal vena cava that would alter its size. Our hypothesis was the ratio of the diameter of the abdominal aorta to caudal vena cava would be higher in dogs with systemic hypertension compared to dogs with normal blood pressure. The mean abdominal aorta‐caudal vena cava ratio was 1.028 in control dogs with a normal blood pressure and 1.515 in dogs with systemic hypertension. In dogs with confirmed systemic hypertension, the abdominal aorta was dilated compared to the caudal vena cava in the caudal abdomen. An increase in the abdominal aorta‐caudal vena cava ratio in a dog should raise suspicion for the presence of systemic hypertension and prompt evaluation of blood pressure.

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“…Previous studies have found that ultrasound can be useful in assessing dehydration using the IVC/Ao ratio, with an IVC/Ao ratio less than 0.8 being the threshold established as a clinical marker of severe dehydration in American children. [12] A recent prospective, observational study by Kwon et al [13] evaluated dehydration in children using ultrasound by measuring the aorta/IVC cross sectional area (Ao/IVCA) and the aorta/IVC maximal diameter index (Ao/IVCD). They compared the Ao/ IVCA to both the Ao/IVCD and the clinical dehydration scale (CDS).…”

Section: Discussionmentioning

confidence: 99%

Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama

Mazza¹,

Romo²,

Torres³

et al. 2019

World Journal of Emergency Medicine

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BACKGROUND: Dehydration and its associated symptoms are among the most common chief complaints of children in rural Panama. Previous studies have shown that intravascular volume correlates to the ratio of the diameters of the inferior vena cava (IVC) to the aorta (Ao). Our study aims to determine if medical students can detect pediatric dehydration using ultrasound on patients in rural Panama.METHODS: This was a prospective, observational study conducted in the Bocas del Toro region of rural Panama. Children between the ages of 1 to 15 years presenting with diarrhea, vomiting, or parasitic infection were enrolled in the study. Ultrasound measurements of the diameters of the IVC and abdominal aorta were taken to assess for dehydration.RESULTS: A total of 59 patients were enrolled in this study. Twenty-four patients were clinically diagnosed with dehydration and 35 were classified to have normal hydration status. Of the 24 patients with dehydration, half (n=12) of these patients had an IVC/Ao ratio below the American threshold of 0.8. Of the remaining asymptomatic subjects, about half (n=18) of these subjects also had an IVC/Ao ratio below the American threshold of 0.8. CONCLUSION:Our study did not support previous literature showing that the IVC/Ao ratio is lower in children with dehydration. It is possible that the American standard for evaluating clinical dehydration is not compatible with the rural pediatric populations of Panama.

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

Cited by 19 publications

References 13 publications

Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs

Aortic to caudal vena cava ratio measurements using abdominal ultrasound are increased in dogs with confirmed systemic hypertension

Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama

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