Comparison of vena cava distensibility index and pulse pressure variation for the evaluation of intravascular volume in critically ill children


Akyıldız B., Özsoylu S.

Jornal de Pediatria, 2021 (Journal Indexed in SCI Expanded) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2021
  • Doi Number: 10.1016/j.jped.2021.04.005
  • Title of Journal : Jornal de Pediatria
  • Keywords: Child, Critically ill, Pulse pressure variation, Vena cava distensibility index

Abstract

© 2021 Sociedade Brasileira de PediatriaObjective: In this study, the authors aimed to evaluate the effectiveness of the vena cava distensibility index (dIVC) and pulse pressure variation (PPV) as dynamic parameters for estimating intravascular volume in critically ill children. Methods: Patients aged 1 month to 18 years, who were hospitalized in the present study's pediatric intensive care unit, were included in the study. The patients were divided into two groups according to central venous pressure (CVP): hypovolemic (< 8 mmHg) and non-hypovolemic (CVP ≥ 8 mmHg) groups. In both groups, dIVC was measured using bedside ultrasound and PPV. Measurements were recorded and evaluated under arterial monitoring. Results: In total, 19 (47.5%) of the 40 subjects included in the study were assigned to the CVP ≥ 8 mmHg group, and 21 (52.5%) to the CVP < 8 mmHg group. A moderate positive correlation was found between PPV and dIVC (r = 0.475, p < 0.01), while there were strong negative correlations of CVP with PPV and dIVC (r = –0.628, p < 0.001 and r = –0.760, p < 0.001, respectively). In terms of predicting hypovolemia, the predictive power for dIVC was > 16% (sensitivity, 90.5%; specificity, 94.7%) and that for PPV was > 14% (sensitivity, 71.4%; specificity, 89.5%). Conclusion: dIVC has higher sensitivity and specificity than PPV for estimating intravascular volume, along with the advantage of non-invasive bedside application.