Evaluation of Fluid Status of Children in Pediatric Intensive Care Unit by Measuring Inferior Vena Cava Diameter

Introduction:The aim of this study was to determine the correlation between Inferior Vena Cava (IVC) diameter, vena cava inferior collapsibility (cIVC) and vena cava inferior distensibility (dIVC) with other hemodynamic parameters to determine the fluid requirement or volume load of patients hospitalised in the pediatric intensive care unit.Methods: Sixty-two patients aged 1 month-18 years were included in this study.IVC diameters were measured, collapsibility and distensibility were calculated to predict the fluid status of the patients.Physical examination findings, biochemical markers, perfusion indices (PI), pleth variability indices (PVI) were also evaluated.Results: There were 33 girls and 29 boys, aged between 3-211 months.IVC minimum diameter (D min ) varied between 0.27 and 2.10 cm, while IVC maximum diameter (D max ) varied between 0.56 and 2.90 cm and there was a very strong relationship between D max and D min in the same direction (r=0.956,p<0.001).There was a positive correlation between D min and cIVC or dIVC among patient groups according to mechanical ventilation (MV) support status.In contrast, there was a negative correlation between PI and PVI and cIVC in patients without MV support (r=-0.355,p=0.040; r=-0.404,p=0.018).There was a positive correlation between D min and D max (r=0.928,p<0.001).There was also a positive correlation between PVI and PI and a negative correlation between lactate (r=0.393,p=0.02; r=-0.272,p=0.033). Conclusion:The high cIVC in spontaneously breathing patients may be associated with intravascular fluid loss.However, more patients are needed to comment on patients receiving MV support.