Home⇛The PCMC Journal⇛vol. 16 no. 1 (2020)

Correlation of Ultrasound Measurement of Inferior Vena Cava to Aorta Diameter Ratio with Hematocrit Levels and Severity of Shock Among Children with Dengue Fever Seen at the Emergency Room of a Tertiary Government Hospital admitted in a tertiary pediatric

Mellinor Ang | Charisse Joy Lim | Cristan Q. Cabanilla | Michael D Cabato

Discipline: medicine by specialism

 

Abstract:

BACKGROUND: Severe dengue is a leading cause of serious illness and death, and intensive supportive care is the most important aspect of management. Before fluid resuscitation, a baseline hematocrit is obtained, and frequent monitoring of the complete blood count is needed. OBJECTIVE: To determine the correlation of ultrasound measurement of inferior vena cava (IVC) to aorta (Ao) diameter ratio with hematocrit levels and severity of shock among children with dengue fever. METHODOLOGY: This is a prospective study design conducted at the Emergency Room of Philippine Children‘s Medical Center. Clinical data and hematocrit of the children with dengue fever aged 1 month to 17 years and 364 days old were documented. The Inferior vena cava diameter (IVC)and the Aorta (Ao) diameter ratio was determined using bedside ultrasound. RESULTS: The IVC/Ao diameter ratio correlates with high hematocrit and dengue shock in children. There is a significantly higher proportion of subjects with a hematocrit of normal range of age among those with a ratio 1.0. A ratio of <0.8 is significantly associated with high hematocrit level for age. Overall, IVC/Ao diameter ratio was significantly associated with severity of Dengue illness. Sensitivity of IVC/Ao diameter ratio of <1.00 in predicting dengue with warning signs and severe dengue was 87.7%. Specificity was higher at 97.1%. Measurement of IVC/Ao diameter ratio has high interrater and intrarater reliability. CONCLUSION AND RECOMMENDATION: IVC/Ao diameter ratio was significantly associated with severity of dengue illness. It should be used to aid decision?making and monitor response to treatments in dengue fever.



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