Sonographic measurement of inferior vena cava diameter in assessment of volume status in pediatric shock: A prospective observational study.

Authors

  • Dr. Vidhyadhar V Assistant Professor, Department of Pediatrics, East Point College of Medical Sciences and Research Centre, Bangalore, India.
  • Dr. Sowmya N Assistant Professor, Department of Pediatrics, East Point College of Medical Sciences and Research Centre, Bangalore, India.
  • Dr. Manu Srinivas H Associate Professor, Department of Pediatric Radiology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India.
  • Dr.Muralidhar G Professor, Department of Pediatrics, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, India.
  • Basavaraja G V Professor, Department of Pediatrics, Indira Gandhi Institute of Child Health, Bangalore, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1849

Keywords:

Pediatric Shock, Inferior Vena Cava, IVC/Aortic Ratio, Ultrasound, Volume Status Assessment

Abstract

Background
Accurate assessment of intravascular volume status in pediatric shock remains a clinical challenge, often relying on subjective and invasive methods. Bedside ultrasonography of the inferior vena cava (IVC) has emerged as a promising, non-invasive modality to estimate volume status. This study aimed to evaluate the IVC diameter and IVC-to-aortic (IVC/Ao) ratio as objective indicators of hypovolemia in children using ultrasound.

Objectives: To obtain and analyze data on IVC diameter and IVC/Ao ratio measured by sonography for assessing intravascular volume status in infants and children with clinical shock compared to euvolemic controls.

 Methods
In this prospective observational study, 60 children aged 1 month to 18 years admitted with clinical shock were compared with 60 age-matched euvolemic controls. Sociodemographic characteristics, including age and sex, were recorded. Maximum sagittal IVC diameter, transverse aortic diameter, and IVC/Ao ratio were measured using bedside ultrasound.

 

Results
The mean age of participants was comparable; the male-to-female ratio was 0.6:1 in the shock group and 1:1.2 in controls. The mean IVC diameter was significantly lower in the shock group (0.99±0.45 cm) than in controls (1.46±0.52 cm; p<0.001), indicating intravascular hypovolemia. The IVC/Ao ratio was also reduced in shock cases (0.65±0.10) compared to controls (0.98±0.09; p<0.001). No significant difference was observed in aortic diameters.

 Conclusion
Ultrasound-derived measurements of IVC diameter and IVC/Ao ratio are reliable non-invasive indicators of hypovolemia in pediatric shock.

 Recommendations
Bedside ultrasound should be integrated into the routine evaluation of children with suspected shock to improve early detection and guide fluid management.

Author Biographies

Dr. Vidhyadhar V, Assistant Professor, Department of Pediatrics, East Point College of Medical Sciences and Research Centre, Bangalore, India.

Dr. Vidhyadhar V is currently serving as an Assistant Professor in the Department of Pediatrics at East Point College of Medical Sciences and Research Centre, Bangalore, India. He completed his MBBS from M.S. Ramaiah Medical College and obtained his MD in Pediatrics from the esteemed Indira Gandhi Institute of Child Health, Bangalore. With over five years of teaching experience, he has successfully mentored undergraduate students in various academic projects, particularly in the fields of pediatrics and neonatology.ORCID ID:https://orcid.org/0009-0006-8976-7874

Dr. Sowmya N, Assistant Professor, Department of Pediatrics, East Point College of Medical Sciences and Research Centre, Bangalore, India.

Dr. Sowmya N is an Assistant Professor in the Department of Pediatrics at East Point College of Medical Sciences and Research Centre, Bangalore. She earned her MBBS from Basaveshwara Medical College and Hospital, Chitradurga, and completed her MD in Pediatrics from the reputed Karnataka Institute of Medical Sciences, Hubballi. With over two years of teaching experience, she has successfully guided undergraduate students in research projects focused on pediatric and neonatal care. ORCID ID: https://orcid.org/0009-0006-2294-3271

Dr. Manu Srinivas H, Associate Professor, Department of Pediatric Radiology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India.

Dr. Manu Srinivas H is currently serving as an Associate Professor and Head of the Department of Pediatric Radiology at the Indira Gandhi Institute of Child Health, Bangalore. He completed his MBBS from M.S. Ramaiah Medical College, Bangalore, followed by an MD in Radiology from Meenakshi Medical College, Kancheepuram. With over 12 years of teaching experience, he has mentored numerous post-MD pediatric radiology fellowship students. He has published two research papers in reputed journals and actively contributes to imaging services across various pediatric subspecialties.ORCID ID:https://orcid.org/0009-0006-7660-3256

Dr.Muralidhar G, Professor, Department of Pediatrics, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, India.

Dr. Muralidhar G is a Professor of Pediatrics at Chettinad Hospital and Research Institute, Kelambakkam, Chennai. He obtained his MBBS from Siddhartha Government Medical College, Vijayawada, and completed his MD in Pediatrics from Kakatiya Medical College, Warangal. With over 10 years of teaching experience, he has successfully guided both undergraduate and postgraduate students. He has published five research papers in reputed journals, primarily focusing on pediatric and neonatal health. ORCID ID: https://orcid.org/0009-0003-7284-6021

Basavaraja G V, Professor, Department of Pediatrics, Indira Gandhi Institute of Child Health, Bangalore, India.

Bangalore. He completed his MBBS from Bangalore Medical College and Research Centre, followed by an MD in Pediatrics from the prestigious SMS Medical College, Jaipur, Rajasthan. With over 25 years of teaching experience, he has mentored numerous undergraduate and postgraduate students in research, particularly in pediatrics and neonatology. Dr. Basavaraja has published over 50 research articles in reputed national and international journals. He has also served as the Honorary Secretary General and National President of the Indian Academy of Pediatrics from 2020 to 2025.ORCID ID: https://orcid.org/0009-0001-0853-3843

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Published

2025-06-30

How to Cite

Vidhyadhar V, Sowmya N, Srinivas H, M. ., Muralidhar G, & Basavaraja G V. (2025). Sonographic measurement of inferior vena cava diameter in assessment of volume status in pediatric shock: A prospective observational study. Student’s Journal of Health Research Africa, 6(6), 11. https://doi.org/10.51168/sjhrafrica.v6i6.1849

Issue

Vol. 6 No. 6 (2025): June 2025 Issue

Section

Section of Pediatrics and Child Health

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Copyright (c) 2025 Dr. Vidhyadhar V, Dr. Sowmya N, Dr. Manu Srinivas H, Dr.Muralidhar G, Basavaraja G V

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