We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Ultrasound Assessment of Severe Dehydration in Children With Diarrhea and Vomiting.
- Authors
Levine, Adam C.; Shah, Sachita P.; Umulisa, Irenee; Munyaneza, Richard B. Mark; Dushimiyimana, Jean Marie; Stegmann, Katrina; Musavuli, Juvenal; Ngabitsinze, Protogene; Stulac, Sara; Epino, Henry M.; Noble, Vicki E.
- Abstract
Objectives: The objective of this study was to determine the test characteristics for two different ultrasound (US) measures of severe dehydration in children (aorta to inferior vena cava [IVC] ratio and IVC inspiratory collapse) and one clinical measure of severe dehydration (the World Health Organization [WHO] dehydration scale). Methods: The authors enrolled a prospective cohort of children presenting with diarrhea and/or vomiting to three rural Rwandan hospitals. Children were assessed clinically using the WHO scale and then underwent US of the IVC by a second clinician. All children were weighed on admission and then fluid-resuscitated according to standard hospital protocols. A percent weight change between admission and discharge of greater than 10% was considered the criterion standard for severe dehydration. Receiver operating characteristic (ROC) curves were created for each of the three tests of severe dehydration compared to the criterion standard. Results: Children ranged in age from 1 month to 10 years; 29% of the children had severe dehydration according to the criterion standard. Of the three different measures of dehydration tested, only US assessment of the aorta/IVC ratio had an area under the ROC curve statistically different from the reference line. At its best cut-point, the aorta/IVC ratio had a sensitivity of 93% and specificity of 59%, compared with 93% and 35% for IVC inspiratory collapse and 73% and 43% for the WHO scale. Conclusions: Ultrasound of the aorta/IVC ratio can be used to identify severe dehydration in children presenting with acute diarrhea and may be helpful in guiding clinical management. ACADEMIC EMERGENCY MEDICINE 2010; 17:1035-1041 © 2010 by the Society for Academic Emergency Medicine
- Subjects
RWANDA; ABDOMINAL aorta; ANALYSIS of variance; BODY weight; COMPUTER software; CONFIDENCE intervals; DEHYDRATION; DIARRHEA; FLUID therapy; LONGITUDINAL method; NURSING assessment; NUTRITIONAL assessment; PEDIATRICS; PHYSICAL diagnosis; PHYSICIANS; PROBABILITY theory; RURAL conditions; RURAL hospitals; STATISTICAL sampling; STATISTICS; VENA cava inferior; VOMITING; DATA analysis; INTER-observer reliability; RECEIVER operating characteristic curves; DIAGNOSIS; DISEASE complications; ULTRASONIC imaging; CHILDREN; THERAPEUTICS
- Publication
Academic Emergency Medicine, 2010, Vol 17, Issue 10, p1035
- ISSN
1069-6563
- Publication type
Article
- DOI
10.1111/j.1553-2712.2010.00830.x