Author:

Abstract

Introduction: Bedside echocardiography is an important screening tool for evaluating intravascular volume status and cardiac functions in the paediatric intensive care unit (PICU). It offers a good image of the heart and is a useful bedside imaging modality and an accurate diagnostic tool.

Objectives: To detect the role of echocardiography in PICUs in the management of critical patients.

Method: It was a descriptive, observational and prospective case control study in a tertiary care children’s hospital from 1^st August 2018 to 31^st July 2019. Critically ill children were admitted from the emergency paediatric department or directly from the outpatient department. Eighty three of 100 critically ill PICU children, who fulfilled the study criteria, were included. Initial echocardiogram was done within 48 hours of admission and repeat echocardiograms as and when indicated.

Results:During the study period, 100 children were admitted to the PICU, 83% being critical. Left ventricular hypertrophy (LVH) was noted in 22.9% and high left ventricular mass index (LVMI) was noted in children with abnormal renal profile, hypertension and hypocalcaemia. Left ventricular (LV) systolic dysfunction was significant in the sepsis group of patients and those who had a PICU stay of more than 10 days duration. Isolated LV diastolic dysfunction was found in 88.7%. Abnormal right ventricular (RV) function was noted in 68.7%. Inferior vena cava collapsibility index (IVC-CI) more than 55% was found in 26.5% and IVC-distensibility index (IVC-DI) more than 18% in 91.6%, suggestive of fluid responsive states. 2D-echocardiography evaluation warranted medical intervention in 69.9% patients in the PICU. Ten (12%) children expired during study period.

Conclusions: In the PICU, echocardiography is a very useful tool in the management of critical patients.

Sri Lanka Journal of Child Health, 2023; 52(1): 81-85

Keywords: Functional echocardiography, Paediatric intensive care unit, Paediatric cardiac functions