Focused critical care echocardiography: training for pediatricians and pediatric intensivists in an intensive care unit
Keywords:
Echocardiography, Critical Illness, Pediatricians, Intensive Care Units, Physicians
Abstract
Introduction:
Focused critical care echocardiography (FCCE) has become a necessary competency for physicians working in pediatric intensive care units.
Objective:
To asses a theoretical and practical training program designed to explore skills acquisition for obtaining views and some echocardiographic measurements suggested for FCCE.
Materials and methods:
A 26-hour long theoretical and practical training for pediatricians and pediatric intensivists under the guidance of a pediatric cardiologist. The program included qualitative analysis of the variables pertaining to basic echocardiographic windows, and quantitative analysis of FCCE.
Results:
There were significant differences between having prior echocardiography knowledge, associated with a higher score in the 4-chamber apical window (mean: 9.0; standard deviation [SD]: 1.02; P = 0.021), and better correlation with the pediatric cardiologist regarding left ventricular function measurements (mean: 92.02; SD: 6.3; P = 0.036).
Conclusion:
The program was useful for basic level training in FCCE with an optimal level of acquisition of the main echocardiographic windows and some echocardiographic measurements.
References
1. Oren-Grinberg A, Talmor D, Brown SM. Concise definitive review: focused critical care echocardiography in the ICU. Crit Care Med 2013;41:2618-2626.
2. Beaulieu Y. Specific skill set and goals of focused echocardiography for critical care clinicians. Crit Care Med 2007;35 (5 suppl):S144-S149.
3. Singh Y. Echocardiographic evaluation of hemodynamics in neonates and children. Front Pediatr 2017;15:201.
4. Amaral Gaspar H, Saady Morhy S. The role of focused echocardiography in pediatric intensive care: a critical appraisal. Bio Med Res Int 2015;2015:1-7.
5. Manasia AR, Nagaraj HM, Kodali RB, et al. Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by non-cardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth 2005;19:155-159.
6. Noritomi DT, Vieira MLC, Mohovic T, et al. Echocardiography for hemodynamic evaluation in the intensive care unit. Shock 2010;34:59-62.
7. Spencer KT, Kimura BJ, Korcarz CE, et al. Focused cardiac ultrasound: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2013;26:567-581.
8. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines and standards. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713.
9. Harjola V-P, Mebazaa A, Helutkiene J, et al. Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology. Eur J Heart Fail 2016;18:226-241.
10. Lai WW, Geva T, Shirali GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006;19:1413-1430.
11. Mayo PH, Beaulieu Y, Doelken P, et al. American College of Chest Physicians/La Société de Réanimation de Langue Française Statement on Competence in Critical Care Ultrasonography. Chest 2009;135:1050-1060.
12. Price S, Via G, Sloth E, et al. Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS). Cardiovasc Ultrasound 2008;6:49.
13. Millington SJ, Hewak M, Arntfield RT, et al. Outcomes from extensive training in critical care echocardiography: identifying the optimal number of practice studies required to achieve competency. J Crit Care 2017;40:99-102.
14. Gaudet J, Waechter J, Mclaughlin K, et al. Focused critical care echocardiography: development and evaluation of an image acquisition assessment tool. Crit Care Med 2016;44:e329-e335.
15. Gaspar HA, Morhy SS, Lianza AC, et al. Focused cardiac ultrasound: a training course for pediatric intensivists and emergency physicians. BMC Med Educ 2014;14:25.
16. See KC, Ong V, Ng J, et al. Basic critical care echocardiography by pulmonary fellows: learning trajectory and prognostic impact using a minimally resourced training model. Crit Care Med 2014;42:2169-2177.
17. Croft LB, Duvall WL, Goldman ME. A pilot study of the clinical impact of handcarried cardiac ultrasound in the medical clinic. Echocardiography 2006;23:439-446.
18. Longjohn M, Wan J, Joshi V, et al. Point-of-care echocardiography by pediatric emergency physicians. Pediatr Emerg Care 2011;27:693-696.
19. Guzmán MC, Izquierdo LM, Carvajal D, et al. Clinical outcomes of pulmonary hypertension in children with pneumonia and respiratory failure. J Respir Disord 2017;2:1-6.
20. Krishnan S, Schmidt GA. Acute right ventricular dysfunction: real-time management with echocardiography. Chest 2015;147:835-846.
21. Ventetuolo CE, Klinger JR. Management of acute right ventricular failure in the intensive care unit. Ann Am Thorac Soc 2014;11:811-822.
2. Beaulieu Y. Specific skill set and goals of focused echocardiography for critical care clinicians. Crit Care Med 2007;35 (5 suppl):S144-S149.
3. Singh Y. Echocardiographic evaluation of hemodynamics in neonates and children. Front Pediatr 2017;15:201.
4. Amaral Gaspar H, Saady Morhy S. The role of focused echocardiography in pediatric intensive care: a critical appraisal. Bio Med Res Int 2015;2015:1-7.
5. Manasia AR, Nagaraj HM, Kodali RB, et al. Feasibility and potential clinical utility of goal-directed transthoracic echocardiography performed by non-cardiologist intensivists using a small hand-carried device (SonoHeart) in critically ill patients. J Cardiothorac Vasc Anesth 2005;19:155-159.
6. Noritomi DT, Vieira MLC, Mohovic T, et al. Echocardiography for hemodynamic evaluation in the intensive care unit. Shock 2010;34:59-62.
7. Spencer KT, Kimura BJ, Korcarz CE, et al. Focused cardiac ultrasound: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2013;26:567-581.
8. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines and standards. Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713.
9. Harjola V-P, Mebazaa A, Helutkiene J, et al. Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology. Eur J Heart Fail 2016;18:226-241.
10. Lai WW, Geva T, Shirali GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006;19:1413-1430.
11. Mayo PH, Beaulieu Y, Doelken P, et al. American College of Chest Physicians/La Société de Réanimation de Langue Française Statement on Competence in Critical Care Ultrasonography. Chest 2009;135:1050-1060.
12. Price S, Via G, Sloth E, et al. Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS). Cardiovasc Ultrasound 2008;6:49.
13. Millington SJ, Hewak M, Arntfield RT, et al. Outcomes from extensive training in critical care echocardiography: identifying the optimal number of practice studies required to achieve competency. J Crit Care 2017;40:99-102.
14. Gaudet J, Waechter J, Mclaughlin K, et al. Focused critical care echocardiography: development and evaluation of an image acquisition assessment tool. Crit Care Med 2016;44:e329-e335.
15. Gaspar HA, Morhy SS, Lianza AC, et al. Focused cardiac ultrasound: a training course for pediatric intensivists and emergency physicians. BMC Med Educ 2014;14:25.
16. See KC, Ong V, Ng J, et al. Basic critical care echocardiography by pulmonary fellows: learning trajectory and prognostic impact using a minimally resourced training model. Crit Care Med 2014;42:2169-2177.
17. Croft LB, Duvall WL, Goldman ME. A pilot study of the clinical impact of handcarried cardiac ultrasound in the medical clinic. Echocardiography 2006;23:439-446.
18. Longjohn M, Wan J, Joshi V, et al. Point-of-care echocardiography by pediatric emergency physicians. Pediatr Emerg Care 2011;27:693-696.
19. Guzmán MC, Izquierdo LM, Carvajal D, et al. Clinical outcomes of pulmonary hypertension in children with pneumonia and respiratory failure. J Respir Disord 2017;2:1-6.
20. Krishnan S, Schmidt GA. Acute right ventricular dysfunction: real-time management with echocardiography. Chest 2015;147:835-846.
21. Ventetuolo CE, Klinger JR. Management of acute right ventricular failure in the intensive care unit. Ann Am Thorac Soc 2014;11:811-822.
How to Cite
1.
Puente-Reyes C, Plazas-Castro H, Guzmán MC, León OJ, Izquierdo LM, Rodríguez C. Focused critical care echocardiography: training for pediatricians and pediatric intensivists in an intensive care unit. Colomb. J. Anesthesiol. [Internet]. 2019 Jan. 1 [cited 2024 Apr. 18];47(1):23-31. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/124
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Published
2019-01-01
How to Cite
1.
Puente-Reyes C, Plazas-Castro H, Guzmán MC, León OJ, Izquierdo LM, Rodríguez C. Focused critical care echocardiography: training for pediatricians and pediatric intensivists in an intensive care unit. Colomb. J. Anesthesiol. [Internet]. 2019 Jan. 1 [cited 2024 Apr. 18];47(1):23-31. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/124
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