Thoracic Ultrasound Applications
This prospective, observational study at the Giannina Gaslini Children’s Hospital aimed to assess the utility of ultrasound-based measurements, specifically inferior vena cava (IVC) metrics, in evaluating dehydration severity in children. Conducted between July and October 2022, the study included patients aged ≤14 years who presented to the Pediatric Emergency Department with suspected moderate-to-severe dehydration based on clinical criteria like oral rehydration failure, vomiting, diarrhea, and signs of fluid deficit (e.g., reduced skin turgor and oliguria). Blood samples were collected to measure biomarkers such as venous pH, uric acid, sodium, bicarbonate, and blood urea nitrogen (BUN). Exclusions included children with underlying cardiac, liver, or kidney diseases or life-threatening conditions.
Point-of-care ultrasound
Point-of-care ultrasound (POCUS) scans, performed prior to fluid therapy, measured the cross-sectional areas of the IVC and aorta (Ao) to calculate the IVC/Ao area ratio. Additionally, the study evaluated the IVC collapsibility index and visualized the “kiss sign,” characterized by complete IVC wall collapse during inspiration. Ultrasound procedures were conducted using high-quality machines with convex probes by trained pediatric emergency physicians.
This study explores the potential of bedside ultrasonography as a non-invasive, cost-effective tool for assessing intravascular volume, complementing biochemical tests for dehydration management. However, due to existing variability in IVC ultrasound literature, its validation remains challenging.
