Interobserver reliability of sonographic measurement of inferior vena cava and aorta parameters in fasting children in the perioperative period: A prospective observational study.

Abstract

Background and aims: Point-of-care ultrasound conducted by anesthesiologists plays a crucial role in ensuring the safety of anesthesia. This study aims to evaluate the interobserver reliability of ultrasound measurements of the inferior vena cava (IVC) and aorta diameters in fasting pediatric patients undergoing spontaneous and controlled ventilation. Despite the prevalent use of indices for intravascular volume assessment, their accuracy varies depending on the observer's expertise, particularly in pediatric cases. This research seeks to provide valuable insights into the interobserver reliability of ultrasound measurements in pediatric patients.

Material and methods: A single-center prospective observational study was conducted involving pediatric patients aged 1-12 years undergoing elective surgery. Ethical approval and written consent were obtained, with exclusions for major cardiovascular issues. Ultrasound measurements of IVC and aorta were performed by two observers during spontaneous and controlled ventilation in the subxiphoid transabdominal long-axis view. Reliability was assessed through statistical analyses, including the intraclass correlation coefficient and Bland-Altman analysis.

Results: Mean values of IVC and aorta diameters were summarized for both observers during different ventilation modes. The intraclass correlation coefficient indicated excellent to good agreement between the observers for both spontaneous and controlled ventilation scenarios. Bland-Altman analysis revealed no fixed or proportional errors, confirming the reliability of the measurements.

Conclusions: This study establishes the reliability of ultrasound measurements for assessing IVC and aorta in subxiphoid transabdominal long-axis view. The findings highlight the potential of this technique in pediatric anesthesia, even after brief training, providing valuable insights for clinical practice.