Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama

Genevieve Mazza; Carina Mireles Romo; Marlene Torres; Ali Duffens; Annasha Vyas; Katherine Moran; Joshua Livingston; Savannah Gonzales; Shadi Lahham

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Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama

Author: Genevieve Mazza ¹ ; Carina Mireles Romo ¹ ; Marlene Torres ¹ ; Ali Duffens ¹ ; Annasha Vyas ¹ ; Katherine Moran ¹ ; Joshua Livingston ¹ ; Savannah Gonzales ¹ ; Shadi Lahham ²
Author Information

1. School of Medicine, University of California Irvine, Irvine, CA 92697, USA
2. Department of Emergency Medicine, University of California Irvine, Orange, CA 92868, USA
Publication Type:Journal Article
Keywords: Ultrasound; Parasitic infection; Panama; Rural medicine; Dehydration; Medical education
From: World Journal of Emergency Medicine 2019;10(1):46-50
CountryChina
Language:English
Abstract: BACKGROUND: Dehydration and its associated symptoms are among the most common chief complaints of children in rural Panama. Previous studies have shown that intravascular volume correlates to the ratio of the diameters of the inferior vena cava (IVC) to the aorta (Ao). Our study aims to determine if medical students can detect pediatric dehydration using ultrasound on patients in rural Panama.
METHODS: This was a prospective, observational study conducted in the Bocas del Toro region of rural Panama. Children between the ages of 1 to 15 years presenting with diarrhea, vomiting, or parasitic infection were enrolled in the study. Ultrasound measurements of the diameters of the IVC and abdominal aorta were taken to assess for dehydration.
RESULTS: A total of 59 patients were enrolled in this study. Twenty-four patients were clinically diagnosed with dehydration and 35 were classified to have normal hydration status. Of the 24 patients with dehydration, half (n=12) of these patients had an IVC/Ao ratio below the American threshold of 0.8. Of the remaining asymptomatic subjects, about half (n=18) of these subjects also had an IVC/Ao ratio below the American threshold of 0.8.
CONCLUSION: Our study did not support previous literature showing that the IVC/Ao ratio is lower in children with dehydration. It is possible that the American standard for evaluating clinical dehydration is not compatible with the rural pediatric populations of Panama.