The Ratio of Femoral Vein Diameter to Femoral Artery Diameter to Predict Fluid Responsiveness in Children

Study Overview
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Brief Summary
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The hypothesis of the study will be that the ratio of femoral vein diameter to femoral artery diameter will have correlation with fluid status in pediatrics.

Detailed Description
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Proper administration of intravenous fluids is an important part of treating circulatory failure in children and affects the clinical outcome of the management of the child's emergency. Giving a small amount of fluid will cause tissue hypoperfusion and worsen organ dysfunction and cause ischemia. On the other hand, excess fluid interferes with oxygen delivary, exacerbates treatment outcomes, increases complications, and extends both the length of the stay in intensive care and mortality. The use of bedside ultrasound by pediatric intensive care physicians has become so critical in recent years that it is now a component of physical examination in ICUs

Official Title
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The Validity of the Ratio of Femoral Vein Diameter to Femoral Artery Diameter to Predict Fluid Responsiveness in Children

Conditions
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Pediatric ALL, Fluid Overload

Intervention / Treatment
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* Diagnostic Test: Ratio of Femoral Vein Diameter to Femoral Artery Diameter


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children with American society of anaesthesiologist physical status 1-2 2-10 years of age scheduled for elective surgery signs of moderate to severe dehydration Exclusion Criteria: Patients with mild dehydration. Patients with history of significant comorbid conditions or previous laparotomy. Congenital heart disease. Heart failure. Disorder of venous return like arteriovenous fistula, DVT or Varicose veins. Increase intra-abdominal pressure.

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 10 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Ratio of Femoral Vein Diameter to Femoral Artery Diameter|An ultrasound probe will be used to first scan the area of the upper thigh just below the inguinal ligament directing caudally seeking for the femoral vessels. The femoral artery and vein could be observed simultaneously. Under normal conditions, pulsation is an indication of the femoral artery, and its companion is the femoral vein. The mean femoral vein diameter and femoral vein diameter (3-5 diametral lines in different directions) will be measured during cough, crying, or performing the Valsalva maneuvers.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of changes in the ratio of femoral vein diameter to femoral artery diameter | Measurement of changes in the ratio of femoral vein diameter to femoral artery diameter before and after fluid challenge which will be defined as infusion of ringer lactate 10 ml/kg body weight over 20 min. | immediate preoperative period before the induction of general anesthesia |