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| Name | Class |
|---|---|
| University of Ostrava | OTHER |
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Children with clinical signs of severe dehydration will be examined by ultrasound in a supine position during admission. Children aged between 1 and 15years will be divided into three weight groups: 10-20kg, 20-30kg, 30-50kg. Early after admission 1st measurement of diameters of vena cava inferior (VCImax, VCImin) during breathing cycles and diameters of both venae jugulares (VJI dx max, min, VJI sin max, min) before and after passive leg raise maneuver will be recorded. After a defined fluid infusion within 60 minutes, a second examination will be evaluated and compared with the first one. The investigators considered also echocardiography to measure CO changes however they wanted to make it as simple as it might be at emergency during the night shift without an experienced cardiologist.
Only children admitted to the hospital with clinically detectable dehydration (weight loss, dry skin, sunken eyes, no tears) will be evaluated. Weight, noninvasive blood pressure measurement, pulse rate will be recorded. Measurements would be performed with an ultrasound probe with a low frequency (2-5 MHz), a curved array transducer will be used. In the supine position, the ultrasound probe will be placed in the substernal area, in the longitudinal and transversal plane, 1 cm caudal to the confluence of the hepatic veins, and it will be operated in M-mode. The largest (VCImax) and smallest (VCImin) diameters will be measured and the collapsibility index will be calculated (according to the formula: VCImax - VCI min / VCI max x100). Immediately after this examination measurement of the right VJImax, min and the left VJImax, min will be measured again in the supine position, then after passive leg raise (lifting the lower limbs 45st. for at least 1minute ) VJImax, min. and left VJImax, min will be measured. The collapsibility index for right and left VJI would be calculated according to the formula: VJImax - VJI min / VJI max x100. After a defined fluid infusion (20ml/kg, but the maximum volume will be limited to 500ml, this means that over 25kg weight we would apply not more than 500ml) within 60 minutes. A control examination of VCI, right VJI, and left VJI will be evaluated the same way as first and compared with the previous one.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Weight category 10-20kg | Experimental | Pediatric patients with a weight of 10-20kg will be enrolled in this arm. |
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| Weight category 20-30kg | Experimental | Pediatric patients with a weight of 20-30kg will be enrolled in this arm. |
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| Weight category 30-50kg | Experimental | Pediatric patients with a weight of 30-50kg will be enrolled in this arm. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intravenous administration of fluids | Procedure | Intravenous administration of fluids (20ml/kg, but the maximum volume will be limited up to 500ml) within 60 minutes. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in vena cava inferior diameter pre- and post-hydration | Change in vena cava inferior diameter (in millimetres) will be measured before and after hydration. | 60 minutes |
| Change in vena jugularis interna diameter pre- and post-hydration (on the right side) | Change in vena jugularis interna diameter (in millimetres) will be measured before and after hydration (on the right side). | 60 minutes |
| Change in vena jugularis interna diameter pre- and post-hydration (on the left side) | Change in vena jugularis interna diameter (in millimetres) will be measured before and after hydration (on the left side). | 60 minutes |
| Change in collapsibility index pre- and post-hydration | Change in collapsibility index values (in per cent) will be measured before and after hydration. | 60 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation to body surface area | All obtained parameters from the other Outcome Measures will be correlated to the body surface area of the patient (measured in m2) | 60 minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tomáš Zaoral, MD,PhD | University Hospital Ostrava | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Ostrava | Ostrava | Moravian-Silesian Region | 70852 | Czechia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22980368 | Background | Unluer EE, Kara PH. Ultrasonography of jugular vein as a marker of hypovolemia in healthy volunteers. Am J Emerg Med. 2013 Jan;31(1):173-7. doi: 10.1016/j.ajem.2012.07.003. Epub 2012 Sep 11. | |
| 26550073 | Background | Bauman Z, Coba V, Gassner M, Amponsah D, Gallien J, Blyden D, Killu K. Inferior vena cava collapsibility loses correlation with internal jugular vein collapsibility during increased thoracic or intra-abdominal pressure. J Ultrasound. 2015 Sep 18;18(4):343-8. doi: 10.1007/s40477-015-0181-2. eCollection 2015 Dec. |
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The investigators have no plan to share individual participant data with other researchers; the data will be provided upon a written request.
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| ID | Term |
|---|---|
| D005759 | Gastroenteritis |
| D003920 | Diabetes Mellitus |
| D007662 | Ketosis |
| D003681 | Dehydration |
| ID | Term |
|---|---|
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
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The pediatric patients will be divided into three groups, according to weight: 10-20kg, 20-30kg, 30-50kg.
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| 24327086 | Background | Lu GP, Yan G, Chen Y, Lu ZJ, Zhang LE, Kissoon N. The passive leg raise test to predict fluid responsiveness in children--preliminary observations. Indian J Pediatr. 2015 Jan;82(1):5-12. doi: 10.1007/s12098-013-1303-5. Epub 2013 Dec 11. |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D000138 | Acidosis |
| D000137 | Acid-Base Imbalance |
| D014883 | Water-Electrolyte Imbalance |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |