Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock

Background: Essential step in the management of septic shock is prompt recognition at an early stage and prediction of fluid responsiveness. Existing methods of assessing septic shock in children have limited accuracy. This study was conducted to determine the serial inferior vena cava (IVC) dimensi...

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Main Authors: Sankaralingam Umaiorubagam, Indumathy Santhanam, Ravichandran Tiraviyam
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Journal of Pediatric Critical Care
Subjects:
Online Access:http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2022;volume=9;issue=1;spage=10;epage=14;aulast=Umaiorubagam
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author Sankaralingam Umaiorubagam
Indumathy Santhanam
Ravichandran Tiraviyam
author_facet Sankaralingam Umaiorubagam
Indumathy Santhanam
Ravichandran Tiraviyam
author_sort Sankaralingam Umaiorubagam
collection DOAJ
description Background: Essential step in the management of septic shock is prompt recognition at an early stage and prediction of fluid responsiveness. Existing methods of assessing septic shock in children have limited accuracy. This study was conducted to determine the serial inferior vena cava (IVC) dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock. Subjects and Methods: A prospective observational study was conducted from 1 month to 12 years of children with septic shock resuscitated in the emergency department. Serial ultrasound measurements of IVC/aorta ratio were obtained before and after each fluid bolus of 10 ml/kg over 20 min. Chi-square tests were used to find out whether the statistical differences between assessing fluid status with clinical parameters and assessing fluid status with IVC/aorta ratio after fluid boluses were really significant or not. Results: Hundred patients were enrolled and included in the final analysis. Using Chi-square test, there were significant (P < 0.05) strong associations between heart rate, pulse volume, capillary refill time, blood pressure, and IVC/aorta ratio during multiple assessments following fluid boluses. Conclusions: IVC/aorta ratio was statistically significantly associated with volume status and clinical assessment. A single assessment of IVC/aorta ratio did not appear useful. Serial determinations of IVC/aorta ratio emerged statistically significant in the assessment of fluid status in children with septic shock during resuscitation in the emergency department.
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spelling doaj.art-dca97903ca7b4cb3acd15997a9c8afc62022-12-22T01:35:58ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992022-01-0191101410.4103/jpcc.jpcc_85_21Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shockSankaralingam UmaiorubagamIndumathy SanthanamRavichandran TiraviyamBackground: Essential step in the management of septic shock is prompt recognition at an early stage and prediction of fluid responsiveness. Existing methods of assessing septic shock in children have limited accuracy. This study was conducted to determine the serial inferior vena cava (IVC) dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock. Subjects and Methods: A prospective observational study was conducted from 1 month to 12 years of children with septic shock resuscitated in the emergency department. Serial ultrasound measurements of IVC/aorta ratio were obtained before and after each fluid bolus of 10 ml/kg over 20 min. Chi-square tests were used to find out whether the statistical differences between assessing fluid status with clinical parameters and assessing fluid status with IVC/aorta ratio after fluid boluses were really significant or not. Results: Hundred patients were enrolled and included in the final analysis. Using Chi-square test, there were significant (P < 0.05) strong associations between heart rate, pulse volume, capillary refill time, blood pressure, and IVC/aorta ratio during multiple assessments following fluid boluses. Conclusions: IVC/aorta ratio was statistically significantly associated with volume status and clinical assessment. A single assessment of IVC/aorta ratio did not appear useful. Serial determinations of IVC/aorta ratio emerged statistically significant in the assessment of fluid status in children with septic shock during resuscitation in the emergency department.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2022;volume=9;issue=1;spage=10;epage=14;aulast=Umaiorubagaminferior vena cava dimensioninferior vena cava/aorta ratiosepsisshock
spellingShingle Sankaralingam Umaiorubagam
Indumathy Santhanam
Ravichandran Tiraviyam
Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock
Journal of Pediatric Critical Care
inferior vena cava dimension
inferior vena cava/aorta ratio
sepsis
shock
title Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock
title_full Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock
title_fullStr Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock
title_full_unstemmed Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock
title_short Serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary-cerebral assessment in children with septic shock
title_sort serial determination of inferior vena cava dimension and its correlation with clinical cardiopulmonary cerebral assessment in children with septic shock
topic inferior vena cava dimension
inferior vena cava/aorta ratio
sepsis
shock
url http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2022;volume=9;issue=1;spage=10;epage=14;aulast=Umaiorubagam
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