|Year : 2021 | Volume
| Issue : 2 | Page : 65-66
Normative data of inferior vena cava diameters of Indian children: Need of the hour
Department of Pediatric Critical Care, Advanced Pediatric Critical Care Unit, Wanless Hospital, Miraj, Maharashtra, India
|Date of Submission||10-Feb-2021|
|Date of Acceptance||17-Feb-2021|
|Date of Web Publication||10-Mar-2021|
Dr. Vinayak Patki
Department of Pediatric Critical Care, Advanced Pediatric Critical Care Unit, Wanless Hospital, Miraj - 416 410, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Patki V. Normative data of inferior vena cava diameters of Indian children: Need of the hour. J Pediatr Crit Care 2021;8:65-6
|How to cite this URL:|
Patki V. Normative data of inferior vena cava diameters of Indian children: Need of the hour. J Pediatr Crit Care [serial online] 2021 [cited 2021 Apr 20];8:65-6. Available from: http://www.jpcc.org.in/text.asp?2021/8/2/65/311048
Ultrasonography has emerged as a safe, rapid, noninvasive bedside radiological tool, which can provide a focused evaluation to answer a clinical question. Around 9% of children presenting to the emergency department are dehydrated, but there is a lack of reliable objective method to measure the degree of intravascular hypovolemia. The changes in inferior vena cava (IVC) diameters have been shown to predict the volume status in adults. Prior studies have shown that these changes provide accurate estimate of right atrial pressure and volume status and also appear to be a valuable index in assessing fluid status in both spontaneously breathing and mechanically ventilated children with septic shock.,
Readily available baseline data of IVC diameter in normal children are of great help in the rapid assessment of variations in sick children. In the recent past, few studies published the baseline diameters of IVC in normal children., There is a lack of normative data for children and adolescents from India in this context.
In the current issue of Journal of Pediatric Critical Care, Ghosh et al. in their observational study at a tertiary care hospital of South India formulated the normative values for IVC diameter in children and adolescents and assessed its correlation with various somatic parameters in Indian children aged 6 months to 16 years. They observed that the mean maximum and minimum IVC diameter increased significantly with age (r = 0.738, P = 0.00; r = 0.789 P = 0.000) and with body surface area (BSA) (r = 0.73, P = 0.0001; r = 0.77, P = 0.0001).
This study is one of those few Indian studies which published normative data for IVC dimensions and collapsibility index (CI) in children. Authors have provided reference values of IVC diameters for healthy Indian children aged 1 month to 12 years. They revealed a positive correlation of age, height, and weight with both maximum and minimum IVC diameters.
In the present study, the authors also measured IVC-CI of all participants, which was measured by the difference between the maximal (expiratory) and minimal (inspiratory) IVC diameters divided by the maximal diameter. The mean CI was 23.1 ± 11.9 among males and 20.1 ± 11.7 among females from the current study. Taneja et al.'s study found that mean CI was 0.34 ± 0.10 which was slightly higher than the present study and can be contributed to different subject population. Normal range of IVC-CI is 0.35–0.50 in adults with optimal values of 0.40, high as >0.55 and low as <0.35 Like previous studies, the authors did not find any statistically significant correlation between CI and age, height, weight or BSA. Such finding can be explained by the fact that CI does not depend on the somatic parameters of an individual, rather it is dependent on the fluid status.,
The inclusion of children from all age groups and prospective design of the study are the strengths of this study. However, small sample size, exclusion of malnourished children, and selection of subject from the outpatient department of hospital rather than healthy volunteers from community are the limitation of this study. This study represents participants from a specific region of India, and the results cannot be extrapolated to children all over India, where regional differences in the built and nourishment of the children may reflect different IVC values. Further multicentric research with a large sample of healthy volunteer children from the different parts of the country is required to overcome these shortcomings.
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