İshalli Çocuklarda Dehidratasyonun Değerlendirilmesi için Inferior Vena Kava Kollapsibilite Indeksi ve Klinik Ölçeklerin Karşılaştırılması

Abstract

Aim: There is no fair predictor to determine the dehydration level in children. The objective of the study was to investigate the efficacy and reliability of the inferior vena cava collapsibility index by the use of ultrasonography to assess volume status for pediatric patients with acute gastroenteritis. Material and Methods: This prospective study was conducted in a tertiary care hospital between December 2016 and October 2017. Patients were assessed with clinical dehydration scores and their inferior vena cava collapsibility indices were measured. The weights of the children were measured prior to treatment and one week after the improvement of symptoms. The correlation between the dehydration percentage seven days after symptom relief and inferior vena cava collapsibility index and also the correlation between clinical dehydration scale results and dehydration percentage seven days after symptom relief were determined. Results: 190 patients enrolled in the study. 130 (68.4%) patients were found to be mildly dehydrated while 60 (31.6%) patients’ dehydration levels remained moderate to severe, and of these 18 (9.4%) were severely dehydrated. The area under the curve for the caval index was determined as 0.985 (95% CI; 0.959-1). The IVCCI cutoff of >58 produced 98.3% sensitivity, 88.5% specificity, 0.79 PPV, 0.99 NPV, 1.2 +LR, and 1.01 -LR. The AUC for moderate-to-severe dehydration was 0.778 (CI 95%: 0.703-0.854) according to the CDC and 0.764 (95% CI:0.669-0.889) for the Gorelick scale. Conclusion: USG-guided IVC index measurement is an effective and reliable method for determining the dehydration severity in pediatric patients present with acute gastroenteritis.