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Pediatric Surgery International
Published in: Pediatric Surgery International 12/2015

01-12-2015 | Original Article

Surgeon-performed bedside ultrasound to assess volume status: a feasibility study

Authors: Deidre L. Wyrick, Samuel D. Smith, Jeffrey M. Burford, Christopher J. Swearingen, Melvin S. Dassinger

Published in: Pediatric Surgery International | Issue 12/2015

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Abstract

Purpose

Rapid assessment of volume status in children is often difficult. The purpose of this study was to evaluate the feasibility of surgeon-performed ultrasound to assess volume status in patients with hypertrophic pyloric stenosis.

Methods

Ultrasounds were performed on admission and before operation. The diameters of the inferior vena cava (IVC) and aorta (Ao) were measured and IVC/Ao ratios were calculated. Electrolytes were measured on admission and repeated if warranted. Logistic regression was used to associate the clinical outcome, defined as CO2 ≤30 mEq/L, with IVC/Ao ratios. Predictive capacity was estimated from the logistic regression for IVC/Ao ratios. Linear regression was used to estimate associations between CO2 values and IVC/Ao ratios.

Results

Thirty-one patients were enrolled. The IVC/Ao ratio is highly associated with actual CO2 values (P < 0.001) and the clinical outcome (P = 0.004). For every 0.05 unit increase in IVC/Ao ratio, predicted CO2 decreased 1.1 units. For every 0.05 unit increase in the IVC/Ao ratio, the odds of having a CO2 ≤30 mEq/L increased 48 % [OR = 1.48, 95 % CI (1.13,1.94)]. Predictive capacity is maximized at an IVC/Ao ratio of 0.75 as 83.9 % of subjects were correctly classified and specificity and PPV = 100 %.

Conclusions

Surgeon-performed ultrasound to determine IVC/Ao ratio is feasible. An IVC/Ao ratio of 0.75 predicted adequate resuscitation.
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Metadata
Title
Surgeon-performed bedside ultrasound to assess volume status: a feasibility study
Authors
Deidre L. Wyrick
Samuel D. Smith
Jeffrey M. Burford
Christopher J. Swearingen
Melvin S. Dassinger
Publication date
01-12-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 12/2015
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-015-3798-5

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