title: Use of a hand-carried ultrasound device by critical care physicians for the diagnosis of pericardial effusions, decreased cardiac function, and left ventricular enlargement in pediatric patients.
abstract: Prompt diagnosis of children with suggested cardiac disease in the acute care setting is critical for initiation of life-saving therapy. We hypothesized that pediatric critical care physicians could perform limited portable echocardiography in children. Portable hand-carried cardiac ultrasound units with 2.5-MHz phased-array transducers were used (Optigo, Philips Medical Systems, Andover, Mass). Noncardiologists were trained through a 1-hour introductory course and 2 hours of practical training. Portable echocardiography performed by noncardiologists was compared with a standard echocardiogram for diagnostic accuracy. In all, 23 patients (age 3 months-20 years) were screened during 18 months. The presence or absence of a pericardial effusion was correctly diagnosed in 21 of 23 patients (91%). Left ventricular size was correctly determined in 22 of 23 patients (96%). Left ventricular systolic function was correctly diagnosed in 22 of 23 patients (96%). These results show that, with appropriate instruction, pediatric critical care physicians are effective using limited portable echocardiography.
authors.affiliation: Department of Cardiology, Childrden's National Medical Center, Washington, DC 20010, USA.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Spurney
authors.forename: Craig A
authors.initials: CA
authors.lastname: Sable
authors.forename: John T
authors.initials: JT
authors.lastname: Berger
authors.forename: Gerard R
authors.initials: GR
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D002309:Cardiology / Q000193:education; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D004452:Echocardiography / Q000295:instrumentation*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D007223:Infant; D007318:Inservice Training; D008297:Male; D010372:Pediatrics / Q000193:education; D010490:Pericardial Effusion / Q000000981:diagnostic imaging*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*