Transhepatic Versus Subcostal Views to Assess Inferior Vena Cava Variation in Pediatric Patients

Study Overview
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Brief Summary
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Currently, in order to visualize the inferior vena cava (IVC) of the heart using ultrasound, physicians traditionally place the ultrasound probe onto the Subcostal area which is located below the chest in the upper abdomen area. In this location, the pressure from the ultrasound probe is often uncomfortable for adults, and even more so for pediatric patients. Previous research and physician experience have demonstrated that it is possible to visualize the heart in the transhepatic area which is located under the arm on the side of the chest. By placing the ultrasound probe in this location, it is more comfortable for the patient when applying pressure, and this study aims to prove the effectiveness of visualizing the heart through this new location.

Official Title
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Evaluation of Transhepatic Versus Subcostal Inferior Vena Cava Views to Assess Inferior Vena Cava Variation in Pediatric Patients

Conditions
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Inferior Vena Cava Abnormality

Intervention / Treatment
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* Diagnostic Test: Ultrasound Analysis of Inferior Vena Cavae (IVC)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be between ages of 2-18 years of age Have parental consent located at an inpatient/outpatient facility at LPCH Be hemodynamically stable Exclusion Criteria: Emergent Surgical Procedures BMI greater than 24

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Assessment of Inferior Vena Cavae with Subcostal View<br>Patients will have a novel operator attempt to visualize their Inferior Vena Cavae with the probe placed in the subcostal region. | Diagnostic Test: Ultrasound Analysis of Inferior Vena Cavae (IVC)<br>* Novel Operators will attempt to visualize the Inferior Vena Cavae through two different views on the patient's body. The images taken will be interpreted by an expert ultrasound user to determine if the novel operator was successful in locating and evaluating the IVC.<br>|
| Experimental: Assessment of Inferior Vena Cavae with Transhepatic View<br>Patients will have a novel operator attempt to visualize their Inferior Vena Cavae with the probe placed in the transhepatic region. | Diagnostic Test: Ultrasound Analysis of Inferior Vena Cavae (IVC)<br>* Novel Operators will attempt to visualize the Inferior Vena Cavae through two different views on the patient's body. The images taken will be interpreted by an expert ultrasound user to determine if the novel operator was successful in locating and evaluating the IVC.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time | Novel Operators will be timed from the point at which the probe is placed until the image has been and will be evaluated between both the control and experimental groups. | For the entirety of the ultrasound procedure. | 
| Accuracy of the IVC Analysis | Novel Operators will be evaluated by the ultrasound expert who will confirm clinical success in locating the IVC. | For the entirety of the ultrasound procedure. |