Clinical impact and efficacy of bedside echocardiography on patient management in pediatric intensive care units (PICUs): A prospective studySanliay Şahin1, Mutlu Uysal Yazıcı3, Ganime Ayar1, Tülin Köksal1, İbrahim İlker Çetin2, Filiz Ekici2, Abdullah Kocabaş2
1Department of Pediatric Intensive Care, Ankara Childrens, Hematology Oncology Education and Research Hospital; Ankara-Turkey
2Department of Cardiology Division, Ankara Childrens, Hematology Oncology Education and Research Hospital; Ankara-Turkey
3Department of Pediatric Intensive Care Unit, Hacettepe University İhsan Doğramacı Childrens Hospital; Ankara-Turkey
Objective: To determine the indication and necessity of echocardiographic assessment and therapeutic interventions in critically ill children.Keywords: critically ill children, echocardiography, intensivist, mechanical ventilation, pediatric intensive care unit, training
Methods: A total of 140 children, including 75 mechanically ventilated (MV) and 65 spontaneously breathing (SB) children, who were admitted consecutively from March to August 2013 were evaluated prospectively. Data regarding the indication for echocardiography and therapeutic approaches used were documented. For evaluating disease severity, the Pediatric Risk of Mortality Score III (PRISM) was ascertained. The correlation between PRISM score and the requirement of echocardiographic evaluations were analyzed.
Results: Patients ages were between 45 days to 18 years. The male-to-female ratio was 1.33. In 35.4% patients who underwent echocardiographic evaluation, no definitive alteration occurred in treatment approach, whereas in the remaining 64.6% patients, decisive or supplemental information was gathered. Echocardiography was indicated in 88% MV children and 46.2% SB children. Echocardiographic evaluation was necessary in MV children and there was a positive correlation between the PRISM score and the requirement of echocardiographic assessment (p<0.001).
Conclusion: Echocardiographic evaluation is an invaluable tool especially in MV children and the requirement of echocardiographic assessment increases according to clinical severity. Basic training for intensivists in this procedure is crucial and needs to be improved and supported in critically ill.
Sanliay Şahin, Mutlu Uysal Yazıcı, Ganime Ayar, Tülin Köksal, İbrahim İlker Çetin, Filiz Ekici, Abdullah Kocabaş. Clinical impact and efficacy of bedside echocardiography on patient management in pediatric intensive care units (PICUs): A prospective study. Anatol J Cardiol. 2017; 18(2): 136-141
Sorumlu Yazar: Sanliay Şahin, Türkiye