Inferior Vena Cava to Aorta Ratio in Children With Non-Hemorrhagic Shock After Fluid Bolus Using Point of Care Ultrasound

OBJECTIVE: To compare IVC/Ao ratio, IVC collapsibility/distensibility indices before and after the administration of fluid bolus therapy in children with non-hemorrhagic shock using point of care ultrasound, and to correlate the changes in IVC/Ao ratio after fluid bolus therapy with changes in heart rate, shock index, and blood pressure. METHODS: Cross-sectional observational study was conducted in children aged 1 to 12 years with non-hemorrhagic shock requiring fluid bolus therapy. Vital parameters were recorded and IVC diameter, IVC collapsibility/distensibility, IVC/Aorta ratio were measured using point of care ultrasound before and after administration of fluid bolus. RESULTS: IVC/Aorta ratio showed a significant increase [0.79 (0.06) vs. 0.91 (0.07); P<0.001] after fluid bolus. Also, a significant decrease was observed in IVC collapsibility /distensibility indices from 58.29 (8.28) and 49.26 (15.50) to 37.39 (8.03) and 29.51 (10.55), respectively. Change in IVC/Aorta ratio showed a weak positive correlation with change in heart rate (r=0.28), and shock index (r=0.26). CONCLUSIONS: Although IVC/Aorta ratio and IVC indices reflect physiological response to fluid therapy in children with non-hemorrhagic shock, its weak correlation with other clinical parameters limits its clinical utility. Further studies with larger sample sizes are needed to validate these findings.