Correlation Between the Inferior Vena Cava/Aorta (Ivc/Ao) Ratio and Serum Lactate Levels in Children With Renal...

Area of Science:

• Pediatric critical care medicine
• Nephrology
• Diagnostic imaging

Background:

• Acute kidney injury (AKI) is prevalent in critically ill children, significantly affecting mortality and hospital stays.
• Current hemodynamic monitoring methods for early AKI detection in pediatric intensive care units (PICU) often lack specificity.
• Non-invasive indicators are needed to improve early diagnosis and management of pediatric AKI.

Purpose of the Study:

• To investigate the relationship between the inferior vena cava/aortic (IVC/Ao) ratio and serum lactate levels in pediatric patients.
• To assess the utility of the IVC/Ao ratio and serum lactate as non-invasive indicators of renal hemodynamics and tissue perfusion.
• To explore potential improvements in early diagnosis and clinical decision-making for pediatric AKI.

Main Methods:

• A cross-sectional study involving 48 pediatric patients (aged 5-18) with a Pediatric Early Warning Score (PEWS) ≥3 and diagnosed renal disorders.
• AKI diagnosis was confirmed using pRIFLE or KDIGO criteria.
• Inferior vena cava/aortic (IVC/Ao) ratio was measured using transabdominal ultrasound, and serum lactate levels were quantified. Spearman correlation analysis was employed.

Main Results:

• The median IVC/Ao ratio was 0.91 (IQR 0.70-1.10), and median serum lactate was 1.5 mmol/L (IQR 1.1-2.4).
• A significant negative correlation was observed between the IVC/Ao ratio and serum lactate levels (rho = -0.65, p < 0.001).

Conclusions:

• A decreasing IVC/Ao ratio is associated with increasing serum lactate levels in pediatric patients with AKI.
• This inverse relationship suggests the IVC/Ao ratio may serve as a valuable non-invasive marker for assessing renal hemodynamics and perfusion in pediatric AKI.
• Findings support the potential for improved early detection and management strategies for AKI in critically ill children.