Hocus POCUS! Parental quantification of left ventricular ejection fraction using point of care ultrasound: fiction or reality?

Abstract

Background Point of care ultrasound has become increasingly utilized in pediatric settings. The assessment of cardiac function is one such implementation of this. This study aimed to determine the feasibility of parents in acquiring images to assess function using a handheld ultrasound probe and the correlation of shortening fraction measurements by handheld ultrasound with hospital acquired echocardiography. Methods Single-center prospective study in which parents of pediatric patients admitted to the hospital. Parents underwent a 25-minute education session on how to use the handheld ultrasound probe and then were asked to acquire a parasternal short axis and apical four chamber image on their own. Acquired images were reviewed by two physicians to determine adequacy of images to assess systolic cardiac function subjectively and objectively. Shortening fraction was measured using parent-acquired images and then compared to recent hospital acquired shortening fraction. Results A total of 25 parents of 21 patients enrolled and completed the study. Of the enrolled parents, 96% of both parasternal short axis and apical four chamber images acquired were deemed appropriate for subjective assessment of systolic function. Inter-reader variability of shortening fractioning was moderate between two readers. Correlation of shortening fraction measured from parent-acquired images versus hospital acquired images was moderate. Conclusion Parents were able to successfully obtain a parasternal short axis and apical four chamber image adequate to assess function and quantify shortening fraction after a 25-minute education session. This pilot data demonstrates that further exploration of parent performed point of care cardiac assessment may be warranted.