The pediatric BUS has arrived: Is bedside ultrasound in the pediatric intensive care unit a feasible option?*

Khilnani, Praveen

doi:10.1097/pcc.0b013e31822f1140

Cited by 3 publications

(5 citation statements)

References 18 publications

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“…3,10 With the development of technology, the application of CVC under ultrasound guidance increasingly becomes a standard procedure in all pediatric age groups. 7,8,11 In contrary to other techniques, with the ultrasound guidance clinician can select the most appropriate and the safest vessel, thereby ensuring vascular puncture as safe as possible. 11 In many studies performed in adults and children, ultrasound guided central venous catheter insertion has increased the rates of success relative to the "blind" Seldinger method and decreased the rates of complications.…”

Section: Discussionmentioning

confidence: 99%

“…2 In recent years, ultrasound has become a powerful device to assist clinicians in the evaluation of traumatic injuries and to decrease the morbidity associated with procedures in both emergency and critical care. 7,8 In departments like emergency and critical care where time is of utmost importance, the possibility for the clinician to use a cheap imaging method with no radiation is a great advantage to the patient with respect to diagnosis and treatment 7 . In intensive care units ultrasound can be used for interventional procedures (vascular access, lumbar puncture, paracentesis, drainage of pleural effusions), the assessment of hemodynamic status and pneumothorax as well as the monitoring of intracranial pressure 7,8 .…”

Section: Introductionmentioning

confidence: 99%

“…7,8 In departments like emergency and critical care where time is of utmost importance, the possibility for the clinician to use a cheap imaging method with no radiation is a great advantage to the patient with respect to diagnosis and treatment 7 . In intensive care units ultrasound can be used for interventional procedures (vascular access, lumbar puncture, paracentesis, drainage of pleural effusions), the assessment of hemodynamic status and pneumothorax as well as the monitoring of intracranial pressure 7,8 . In this study, we aimed to assess the practices of CVC with the guidance of ultrasound performed at our PICU.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of ultrasound for central venous catheterization in pediatric intensive care unit; a single center experience

Tolunay¹,

Okuyan²,

Çelik³

et al. 2015

Turk J Ped Em Int Care Med

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Methodsby an interventional radiology expert. Subclavian vein was not preferred since it complicated the insertion of the catheter into the clavicle under ultrasound guidance. Adequate anesthesia was achieved prior to the procedure (1 μgr/kg fentanyl); sedation was ensured using midazolam (0,1 mg/kg) or ketamine (1-2 mg/kg). During the procedure, the patients were followed under continuous monitoring of the cardiac rate and rhythm, the respiratory rate and oxygen saturation. Except emergency situations, patients with pre-existing thrombocytopenia and abnormal coagulation test results were given supportive treatment and the catheter was inserted in these patients after the test results returned to normal. Central venous catheters were inserted by the pediatricians employed at the intensive care unit or interventional radiology expert at the pediatric intensive care unit. Double-lumen 4-Fr, triple-lumen 5-Fr, triple-lumen 7-Fr polyurethane transient catheters were used for patients with a body weight below 5 kg, between 5 and 20 kg and above 20 kg, respectively (Guangdong Baihe Medical Technology, China).For the purpose to recognize artery and vein; 1-the anatomic positions of internal jugular and femoral veins relative to arteries (internal jugular vein lies on the lateral side of the common carotid artery, femoral vein lies on the medial side of the femoral artery) (figure 1,2), 2-the compressibility of the internal jugular and femoral veins relative to arteries (figure 1,2), 3-in case of difficulty of discriminating the veins and arteries, the shape of the flow was investigated using Doppler mode of ultrasound (Figure 3). While transverse access was mostly used due to the size of the ultrasound probe, CVC was conducted using longitudinal access with real-time images in older patients (figure 4).Hand hygiene and aseptic conditions were ensured to manage infections. The site of administration was sterilized using 10% povidone iodine. A sterile ultrasound gel (Aquatouch Jelly, Turkey) and sterile transducer cover (Medbar Cardboard Camera Cover, Turkey) was used. While inserting the catheter, a "laptop style" ultrasound device and a straight linear probe (7.5 MHz) was used (Mindray-M5 Ultrasound System, China). The catheters were inserted using the Seldinger technique. The location of the catheter was assessed by posterior-anterior chest radiograph for the internal jugular catheters and the localization was deemed appropriate if the tip of the catheter was in the space between the distal part of vena cava superior and the entrance of the right atrium. Dressings were applied once every two days. Patients exhibiting the same microorganism growth in the catheter culture and the peripheral blood culture with accompanying the sepsis clinical findings and signs were diagnosed as central line-associated bloodstream infection while those with erythema, indurations and tenderness within 2 cm distance around the catheter exit were diagnosed with catheter exit-site infection 9 .

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of ultrasound for central venous catheterization in pediatric intensive care unit; a single center experience

Tolunay¹,

Okuyan²,

Çelik³

et al. 2015

Turk J Ped Em Int Care Med

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“…Critical care ultrasound has been increasingly utilized in India ( 10 – 12 ). A significant number of PICUs in India have started using bedside ultrasound for assessment of critically ill children and monitoring of the therapies ( 13 , 14 ). But the training of the PCCM fellows in India occurs largely based on the traditional “see one, do one and teach one” model.…”

Section: Pccm Training In Indiamentioning

confidence: 99%

Pediatric Critical Care Medicine Training in India: Past, Present, and Future

Bhalala

Khilnani

2018

Front. Pediatr.

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Pediatric critical care services in India have grown with leaps and bounds. There has been a growing need of physicians specially trained in pediatric critical care medicine (PCCM) in India. Physicians returning to India after their formal training in PCCM abroad have partly supported this growing need. Development of formal PCCM training programs in India has been a huge step toward supporting the growing clinical needs. This article focuses on advances in pediatric critical care training in India and its future directions.

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“…[12] Transthoracic echocardiography has been used in adult patients to assess the volume status in the emergency room, though somewhat less commonly, in pediatric patients. [3]…”

mentioning

confidence: 99%

The pediatric BUS has arrived: Is bedside ultrasound in the pediatric intensive care unit a feasible option?*

Cited by 3 publications

References 18 publications

Use of ultrasound for central venous catheterization in pediatric intensive care unit; a single center experience

Use of ultrasound for central venous catheterization in pediatric intensive care unit; a single center experience

Pediatric Critical Care Medicine Training in India: Past, Present, and Future

Bedside ultrasound and echocardiography by the pediatric intensivist: An evolving tool and a feasible option in a pediatric ICU

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