Focused critical care echocardiography: training for pediatricians and pediatric intensivists in an intensive care unit
Focused critical care echocardiography (FCCE) has become a necessary competency for physicians working in pediatric intensive care units.
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.
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).
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.
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.
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