scholarly journals Use of ultrasound for the assessment of dehydration in pediatric patients with mild to moderate dehydration

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Yalda Ravanshad ◽  
Anoush Azarfar ◽  
Seied Ali Alamdaran ◽  
Mitra Naseri ◽  
Gholamreza Sarvari ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Fluid Therapy ◽  
Roc Curve ◽  
Inferior Vena ◽  
Vena Cava ◽  
World Health ◽  
Clinical Scale ◽  
Oral Rehydration ◽  
Significant Difference ◽  
Before And After

Management of children with acute gastroenteritis is based upon dehydration estimation. There is no clinical or paraclinical tool which exactly estimates the dehydration degree. Recently ultrasonographic parameters as inferior vena cava (IVC) diameter and aorta (AO) have been used in some studies for this purpose. This study aims to evaluate the efficacy of ultrasound in detecting mild and moderate degrees of dehydration in children. The study was performed in the emergency department of Dr. Sheikh’s Children Hospital, Mashhad, Iran. Children with mild to moderate degrees of dehydration according to World health Organization (WHO) clinical scale were enrolled. Their inferior vena cava diameters, aorta and IVC/AO ratio were measured before and after fluid therapy using ultrasound. Ultrasound was performed by two pediatric sonographers. 36 patients (mean age of 16.94±11.02 months) entered the study. 11 patients had mild and 25 moderate dehydration according to WHO clinical scale. All 11 patients with mild dehydration received oral rehydration. 13 patients in the moderate dehydration group received intravenous rehydration because of oral intolerance to fluids and recurrent vomiting. IVC diameter and IVC/AO ratio after fluid therapy in children with both mild and moderate dehydration degrees was significantly greater (P<0.001). However, we did not observe any significant difference in aorta diameter before and after fluid therapy. Using Receiver Operating Characteristic (ROC) curve, the proper cut-off point of IVC/AO ratio to differentiate patients with moderate dehydration from mild dehydration is equal to 0.782 with sensitivity and specificity equal to 88% and 45.45% respectively. Further, the area under the ROC curve for this cut-off is equal to 0.569. In conclusion, ultrasonography cannot differentiate between mild and moderate dehydration degrees, but studies with larger population of patients should be performed.

Delta Inferior Vena Cava Index Correlated with Mean Arterial Pressure (MAP) in Spinal Anesthesia

2021 ◽  
Vol 2 (2) ◽  
pp. 65-69
Author(s):  
Wiwi Jaya ◽  
◽  
Ulil Abshor ◽  
Buyung Hartiyo Laksono ◽  
Arie Zainul Fatoni ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Inferior Vena Cava ◽  
Arterial Pressure ◽  
Spinal Anesthesia ◽  
Inferior Vena ◽  
Vena Cava ◽  
Test Study ◽  
Significant Difference ◽  
Before And After ◽  
Post Test

Background: Spinal anesthesia has become an alternative to general anesthesia. However, spinal anesthesia has the most common side effects including, bradycardia and hypotension. The aim of this study was to determine the relationship between changes in the inferior vena cava index (delta inferior vena cava index) to changes in mean arterial pressure in spinal anesthesia. Methods: This study was an observational pre-post test study in thirty-two patients who received spinal anesthesia. The inferior vena cava index (inferior vena cava collectibility index and caval-aorta index) was measured before and after spinal anesthesia (5 and 10 minutes after onset). Data were analyzed using the Kolmogorov Smirnov test, Shapiro-Wilk test, T-test, and correlation test with α=5% Result: There was a significant difference in mean arterial pressure (MAP), delta inferior vena cava collectibility index (D-IVC-CI), and delta caval-aorta index (D-CAo-I) before and after spinal anesthesia. D-IVC-CI and D-CAo-I are significantly correlated with MAP. The correlation between D-IVC-CI and MAP had R = -0.371 (P <0.05) at 5 minutes post-anesthesia, while D-CAo-I and MAP had R = 0.472 (P <0.05) at 10 minutes post-anesthesia. Conclusion: The delta inferior vena cava index is correlated with the mean arterial pressure (MAP) value in spinal anesthesia.

The respiratory variation in inferior vena cava diameter as a guide to fluid therapy

2004 ◽  
Vol 30 (9) ◽  
Author(s):  
Marc Feissel ◽  
Fr�d�ric Michard ◽  
Jean-Pierre Faller ◽  
Jean-Louis Teboul
Keyword(s):  
Inferior Vena Cava ◽  
Fluid Therapy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Respiratory Variation ◽  
Inferior Vena Cava Diameter

A Novel Parameter Derived From Photoplethysmographic Pulse Wave to Predict Risk of Postreperfusion Syndrome

2020 ◽  
Author(s):  
Hai-ying Kong ◽  
Xian Zhao ◽  
Su-Qin Huang
Keyword(s):  
Liver Transplantation ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Pulse Wave ◽  
Surgical Stress ◽  
Vena Cava ◽  
Stress Index ◽  
Increased Risk ◽  
Sympathetic Modulation ◽  
Before And After

Abstract BackgroundPostreperfusion syndrome (PRS), observed after reperfusion of the grafted liver, was associated with poor outcome. The end-stage liver disease (ESLD) with autonomic dysfunction in the cardiovascular system has greater risk of developing of PRS, due to the poor ability in sympathetic vasoconstriction. Surgical Stress Index (SSI) is a novel parameter derived from photoplethysmographic pulse wave to assess central sympathetic modulation in awake volunteers. In this study, we determined the relationship between SSI values and the risk of developing of PRS during orthotopic liver transplantation.MethodsWe retrospectively studied 163 patients who had undergone OLT, and divided the patients into PRS group and non-PRS group. SSI and related parameters were determined 5min before and after clamping of the inferior vena cava, the occurrence of PRS were recorded during reperfusion.ResultsThe clamping of the inferior vena cava modified the SSI significantly, accompanied with significant hemodynamic response. The SSI increased significantly after clamping (47.0 (43.0-49.0 ) vs.81.0(69.5-89.0), p<0.001). The SSI increased by 45.3% at 5min after clamping of the inferior vena cava in the PRS group, as opposed to 81.7% in the non-PRS group (P = 0.037). PRS occurred in only 19.4% of patients in whom the SSI increased by more than 50%. Based on a multivariate analysis, percentage of the variation in the SSI was associated with a significant increased risk in developing the PRS (OR 2.49, 95% CI 1.15-5.02; P=0.021).ConclusionsSSI can sensitively indicate the central sympathetic modulation function during liver transplantation procedure. SSI might be a sensitive marker of risk of developing PRS.

Splanchnic and systemic absorption of intraperitoneal insulin using a new double-tracer method

1994 ◽  
Vol 266 (5) ◽  
pp. E750-E759 ◽  
Author(s):  
J. Radziuk ◽  
S. Pye ◽  
D. E. Seigler ◽  
J. S. Skyler ◽  
R. Offord ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Portal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Systemic Absorption ◽  
Tracer Method ◽  
Total Recovery ◽  
Before And After ◽  
Intraperitoneal Insulin ◽  
Serial Samples

The absorption of a bolus of intraperitoneal insulin into the splanchnic and peripheral circulations was separately assessed in dogs using an infusion of two insulin tracers (A1-[3H]insulin and B1-[3H]insulin). One tracer was infused into the superior mesenteric artery and the second into the jugular vein. Serial samples were taken before and after an injection of insulin (1 U/kg ip). Sampling was from the portal vein and the inferior vena cava. By using the principle of equivalent entry of tracer and unlabeled material, we developed two simultaneous equations for the rate of splanchnic and peripheral insulin absorption at each time point. These were solved to yield the two rates. Mean concentrations in the portal vein were approximately 25% higher than in the inferior vena cava, reflecting the splanchnic absorption. This rate accounted for almost half (51 +/- 9%) of the insulin absorbed. The remainder of the absorption was peripheral. The total recovery of intraperitoneal insulin, absorbed by either route, was 88 +/- 11%. Portal absorption peaked earlier than peripheral. Absorption by both routes was 90% complete within approximately 2 h (131 +/- 16 min). In summary, therefore, intraperitoneal insulin is rapidly and almost completely absorbed, with absorption split between the splanchnic and peripheral routes of entry.

scholarly journals Patterns of Inferior Vena Cava Filter Placement Before and After Implementation of a Strict Indication Policy

2016 ◽  
Vol 64 (3) ◽  
pp. 850
Author(s):  
Nicholas Russo ◽  
Matthew D'Alessandro ◽  
Arthelma Tyson ◽  
Saqib Zia ◽  
Jonathan Schor ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Filter Placement ◽  
Before And After

Sources of Human Plasma Cyclic AMP. Examinations before and after Beta2 Adrenergic Stimulation

1981 ◽  
Vol 9 (6) ◽  
pp. 521-525 ◽  
Author(s):  
Peter Endres ◽  
Christine Klock ◽  
Rolf Günther
Keyword(s):  
Cyclic Amp ◽  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Subcutaneous Injection ◽  
Inferior Vena ◽  
Vena Cava ◽  
Adrenergic Stimulation ◽  
Arterial Blood ◽  
Before And After ◽  
General Influence

Plasma cyclic AMP was measured in different vessels in seventeen volunteers before and after stimulation with terbutaline. Differences between arterial blood and blood from the hepatic vein, right ventricle, inferior vena cava and a cubital vein could not be demonstrated. Only in the renal vein was the concentration of cyclic AMP decreased. Our results indicate that cyclic AMP is not generated from any specific isolated organ and that changes in cyclic AMP after subcutaneous injection of terbutaline reflect a general influence of this drug.

scholarly journals VENOUS DRAINAGE OF KIDNEY;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Robina Shaheen ◽  
Muhammad Nasir Jamil ◽  
Aminullah
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Renal Veins ◽  
Drainage Pattern ◽  
Significant Difference ◽  
Group A ◽  
Group D

Background: In the era of changing trends in favour of laparoscopic andminimally invasive surgery, a better understanding of renal veins is of paramount importance. Although various classifications of renal veins have been proposed,none is without shortcomings. We investigated the drainage pattern of renal veins in cadavers and aim to address the shortcomings in previous classifications by proposing a new classification of renal veins. Study Design: Observational cross-sectional study. Setting: Embalmed cadavers or autopsy cases in anatomy and forensic departments of various medical colleges of Lahore (Fatima Jinnah, King Edwards, Allama Iqbal). Period: One year from Feb2008 to Jan2009. Methods: The kidneys and inferior vena cava were well exposed incases with well-preserved renal vessels and kidneys. A mixture of gelatin and Indian ink were injected into inferior vena cava which in turn filled renal veins. Renal vein patterns were studied. We report frequencies in the proposed renal vein groups and subgroups. Results: A total of 50 pairs of kidneys were studied (50 right, 50 left). The renal veins were classified into five groups (A-E) depending on number and arrangement of primary tributaries that formed renal vein.All groups were further divided into three sub groups (1, 2 and 3) depending on whether or not an additional renal vein or any other variant pattern existed, except group E. Subgroup1 represented normal renal vein across all groups. Groups A, B, C consisted of renal veins formed by union of 2, 3, 4 primary tributaries respectively, all from anterior aspect. Group D consisted of renal veins where a posterior primary tributary existed. While group E included renal veins formed by any other number or pattern of primary tributaries. Group A was the most frequent type overall (40%), more common on the right side (56% vs 24%). Group B was the most frequentgroup on the left side (38%). The least frequent group was group E with equal frequency on both sides (6%), closely preceded by group D, which was more frequent on the left side (12% vs 2%). The only statistically significant difference in relation to major groups between right and left kidneys was in group A (56% vs 24% respectively; P=0.001). Conclusion: We proposed a comprehensive classification of renal veins taking into account their variant and anomalous patterns and tributaries not previously considered by other classifications.Future studies in diverse populations with bigger sample are warranted to investigate some of the patterns not observed in this study.

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