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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Ultrasound
2016 ; 19
(3
): 203-9
Nephropedia Template TP
gab.com Text
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English Wikipedia
Accuracy of the caval index and the expiratory diameter of the inferior vena cava
for the diagnosis of dehydration in elderly
#MMPMID27635166
Orso D
; Guglielmo N
; Federici N
; Cugini F
; Ban A
; Mearelli F
; Copetti R
J Ultrasound
2016[Sep]; 19
(3
): 203-9
PMID27635166
show ga
PURPOSE: Dehydration is a very common condition among elderly people. Till date
there is not yet a fast and easy method to determine a state of dehydration in
the emergency department. In the literature there are some exploratory studies
that have tried to establish the relationship between some widely used laboratory
values and ultrasound for the purpose of diagnosing dehydration. The primary aim
of this study is to verify the correlation between two measures derived by
ultrasound (caval index and expiratory diameter of inferior vena cava) and blood
urea nitrogen (BUN)/creatinine ratio. The relationship between vital signs and
BUN/creatinine ratio has also been explored. METHODS: An observational cohort
study of patients aged 70 years or more, all examined in our ED. The population
was divided on the basis of the BUN/creatinine ratio greater or lower than 20.
RESULTS: A total of 270 patients have been considered. No vital sign correlated
with an increased BUN/creatinine ratio. Both the diameter of the inferior vena
cava in expiratory and the percentage of its collapsibility in inspiratory (caval
index) have revealed a correlation with a BUN/creatinine ratio greater than 20.
Areas under the curve are, respectively, 76 % (95 % CI 70-82) and 80 % (95 % CI
75-86). Sensitivity, specificity, positive predictive value and negative
predictive value are, respectively, 85.5 % (95 % CI 79.4-90.4); 100 % (95 % CI
97-100); 100 % (95 % CI 97.5-100); 82.9 % (95 % CI 75.9-88.7) and 99.3 % (95 % CI
96.3-99.9); 100 % (95 % CI 97-100); 100 % (95 % CI 97.5-100); 99.2 % (95 % CI
95.6-99.9). CONCLUSIONS: Ultrasound has proved to be useful to diagnose
dehydration in elderly people while in the emergency department. Vice versa the
vital signs have shown to be unrelated to the hydration state of elderly
patients.