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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Ultrasound assessment of severe dehydration in children with diarrhea and vomiting
Academic Emergency Medicine, Volume 17, No. 10, Year 2010
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Description
Objectives: The objective of this study was to determine the test characteristics for two different ultrasound (US) measures of severe dehydration in children (aorta to inferior vena cava [IVC] ratio and IVC inspiratory collapse) and one clinical measure of severe dehydration (the World Health Organization [WHO] dehydration scale). Methods: The authors enrolled a prospective cohort of children presenting with diarrhea and/or vomiting to three rural Rwandan hospitals. Children were assessed clinically using the WHO scale and then underwent US of the IVC by a second clinician. All children were weighed on admission and then fluid-resuscitated according to standard hospital protocols. A percent weight change between admission and discharge of greater than 10% was considered the criterion standard for severe dehydration. Receiver operating characteristic (ROC) curves were created for each of the three tests of severe dehydration compared to the criterion standard. Results: Children ranged in age from 1 month to 10 years; 29% of the children had severe dehydration according to the criterion standard. Of the three different measures of dehydration tested, only US assessment of the aorta/IVC ratio had an area under the ROC curve statistically different from the reference line. At its best cut-point, the aorta/IVC ratio had a sensitivity of 93% and specificity of 59%, compared with 93% and 35% for IVC inspiratory collapse and 73% and 43% for the WHO scale. Conclusions: Ultrasound of the aorta/IVC ratio can be used to identify severe dehydration in children presenting with acute diarrhea and may be helpful in guiding clinical management. © 2010 by the Society for Academic Emergency Medicine.
Authors & Co-Authors
Levine, Adam
United States, Providence
The Warren Alpert Medical School
United States, Boston
Partners in Health
Shah, Sachita P.
United States, Providence
The Warren Alpert Medical School
Umulisa, Ireneé
Rwanda, Kigali
Rwinkwavu District Hospital
Mark Munyaneza, Richard B.
Rwanda, Kigali
Rwinkwavu District Hospital
Dushimiyimana, Jean Marie
Rwanda, Kigali
Kirehe District Hospital
Stegmann, Katrina
Rwanda, Kigali
Kirehe District Hospital
Musavuli, Juvenal
Rwanda, Butaro
Butaro District Hospital
Ngabitsinze, Protogene
Rwanda, Butaro
Butaro District Hospital
Stulac, Sara N.
United States, Boston
Partners in Health
Epino, Henry M.
United States, Boston
Partners in Health
Noble, Vicki
United States, Boston
Massachusetts General Hospital
Statistics
Citations: 100
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1111/j.1553-2712.2010.00830.x
ISSN:
10696563
e-ISSN:
15532712
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study