A bedside ultrasound technique for fluid therapy monitoring in severe hypovolemia: Tissue Doppler imaging of the right ventricle

[Index from Diameter of Inferior Vena Cava and Abdominal Aorta of Newborns - A Relevant Method for Evaluation of Hypovolemia]

Hypovolemia is one of the important problems in sick neonates. Ultrasound is a safe, noninvasive diagnostic tool for the assessment of volume status. For that reason, the aim of the study was to determine normal values of the diameter of inferior vena cava (IVC), abdominal aorta (Ao) and the index IVC/Ao.

PATIENTS AND METHODS

97 healthy, term neonates were included in the study and investigated at first and third day of life. The diameter of IVC, Ao was measured and the index from IVC/Ao was estimated. Using statistics mean and median values of the parameters and correlations to birth weight were determined.

RESULTS

Diameter of Ao at first day was 6.1 (+/-0.6) mm and at third day 6.2 (+/-0.6) mm, of IVC at first day was 2.5 (+/-0.5) and at third day 2.61 (+/-0.5). The Index from diameters of IVC/Ao was evaluated at day 1 as 0.4 (+/-0.1) and day 3 as 0.4 (+/-0.1). We found a positive correlation to the birth weight. We identified a significant difference of the index in SGA and LGA - neonates (0.36 vs 0.47). Despite a significant reduced weight from first to third day in the neonates, we determined no influence on the diameter of IVC, Ao and the index IVC/Ao.

CONCLUSION

We determined normal values of diameter of IVC and Ao and the Index of IVC/Ao. It is our opinion, that it is possible to assess the intravascular volume using the index. The importance of the index can be underlined by the results in SGA-neonates. More research is needed to understand some points of the pathophysiology in SGA.