Echocardiography in PICU: when the heart sees what is invisible to the eye

Abstract

Echocardiography had a significant impact on the management of PICU patients. Such salutary effect was consequently reflected on the outcome. Pediatric intensivists are encouraged to acquire such bedside skill.

Clinical impact and efficacy of bedside echocardiography on patient management in pediatric intensive care units (PICUs): A prospective study

“…At the same time, the Portuguese Working Group on Echocardiography has improved the skill-based program FADE to teach clinicians the use of bedside ultrasound to level-1 competency in echocardiography and chest ultrasound, enabling intensivists to determine major causes of hypotension, respiratory failure, and the need for a second opinion. Consistent with the literature, in our study the most common indications were hypotension ( 23 ) and assessment of left ventricular function.…”

“…Bedside echocardiography can image the great veins, ventricular size, and contractility, and is an important, noninvasive, portable, and rapid diagnostic instrument in the PICU facilitating detection of reversible and time dependent conditions early ( 18 – 20 ). Some authors point out that a remarkable change in treatment occurs in only a small percentage of adult patients ( 21 ), whereas some other show that a significant change in management resulted in most of the patients ( 19 , 22 , 23 ). In our study, a decisive or supplemental information was obtained in 64.6% patients.…”

“…In our study, a decisive or supplemental information was obtained in 64.6% patients. To our knowledge, studies available in literature are very few in this regard ( 11 , 23 , 24 ) and our study is first to be conducted prospectively comparing the two groups. Stanko and coauthors reported that TTE resulted in a change in the diagnosis and management frequently ( 25 ).…”

Effectivity of functional echocardiography in paediatric intensive care unit: An observational study

“…The two most frequent indications for echocardiography in the current study were critical normal study, which occurred in 62 (74.7%) patients, and pulmonary hypertension secondary to lung disease, which occurred in 11 (13.3%) patients, whereas the study by Rabah F, et al 9 shows that 27 (26.7%) examinations were performed to evaluate left ventricular function in haemodynamically unstable patients and the second frequent indication was suspicion of congenital heart disease (18.8%). Due to the great sensitivity and specificity of echocardiography, its value extends to the detection of peripheral lung pathology 10 .…”

“…Several studies have detected the valuable effect of the use of echocardiography in the management of critically ill patients, changing their treatment in 30%-60% of cases after echocardiography 6,7 . Several studies were done to evaluate the role of echocardiography in PICU like the study conducted by Şahin S, et al 8 , where echocardiograms were done for 140 out of 186 patients (75.2%) admitted in the PICU over a period of 6 months, and in the study done at the Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman by Rabah F, et al 9 where 82 patients had echocardiography out of 424 patients were admitted in this PICU over a-24-month period. In this research, we have studied 83 patients from a total of 100 patients who were admitted to the PICU.…”