1. Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama
- Author
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Joshua K Livingston, Shadi Lahham, Ali Duffens, Carina Mireles Romo, Genevieve Mazza, Annasha Vyas, Inna Shniter, John C. Fox, Marlene Torres, Katherine Moran, Maxwell A. Thompson, and Savannah Gonzales
- Subjects
Medical education ,Pediatrics ,medicine.medical_specialty ,Parasitic infection ,Panama ,Clinical Sciences ,Rural Health ,030204 cardiovascular system & hematology ,Asymptomatic ,Inferior vena cava ,03 medical and health sciences ,0302 clinical medicine ,Rural medicine ,Clinical Research ,medicine.artery ,Ultrasound ,medicine ,Intravascular volume status ,Pediatric ,Dehydration ,business.industry ,Abdominal aorta ,030208 emergency & critical care medicine ,Diarrhea ,medicine.vein ,Emergency Medicine ,Vomiting ,cardiovascular system ,Biomedical Imaging ,Original Article ,medicine.symptom ,business ,4.2 Evaluation of markers and technologies - Abstract
Author(s): Mazza, Genevieve; Romo, Carina Mireles; Torres, Marlene; Duffens, Ali; Vyas, Annasha; Moran, Katherine; Livingston, Joshua; Gonzales, Savannah; Lahham, Shadi; Shniter, Inna; Thompson, Maxwell; Fox, John Christian | Abstract: BackgroundDehydration 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.MethodsThis 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.ResultsA 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.ConclusionOur 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.
- Published
- 2019
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