Dataset Information

Urgent ultrasound guided hemodynamic assessments by a pediatric medical emergency team: a pilot study.

ABSTRACT:

Purpose

To determine the feasibility of using the Ultrasound Cardiac Output Monitor (USCOM) as an adjunct during hemodynamic assessments by a pediatric medical emergency team (PMET).

Methods

Pediatric in-patients at McMaster Children's Hospital aged under 18 years requiring urgent PMET consultation, were eligible. Patients with known cardiac outflow valve defects, Pediatric Critical Care Unit in-patients, and those in cardiorespiratory arrest, were excluded. The primary outcome was feasibility, and the ease of USCOM transport and application as assessed by a self-administered user questionnaire. Secondary outcomes included the quality of USCOM measurements, and agreement in clinical versus USCOM-derived assessments.

Results

Forty-one patients from 85 eligible PMET consultations were enrolled between March and August 2011. A total of 55 USCOM assessments were performed on 36 of 41 (87.8%) participants. USCOM could not be completed in 5 (12.2%) participants due to patient agitation (n?=?4) and emergent care (n?=?1). USCOM was reported as easy to transport and apply by 97.4% and 94.7% of respondents respectively, not obstructive to patient care by 94.7%, and yielded timely measurements by 84.2% respondents. USCOM tracings were of good quality in 41 (75.9%) assessments. Agreement between clinical and USCOM-derived hemodynamic assessments by two independent raters was poor (Rater 1: ??=?0.094; Rater 2: ??=?0.146).

Conclusion

USCOM can be applied by a PMET during urgent hemodynamic assessments in children. While USCOM has been validated in stable children, its role in guiding hemodynamic resuscitation and informing therapeutic goals in a hemodynamically unstable pediatric population requires further investigation.

SUBMITTER: Zorko DJ

PROVIDER: S-EPMC3692535 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Urgent ultrasound guided hemodynamic assessments by a pediatric medical emergency team: a pilot study.

Zorko David J DJ Choong Karen K Gilleland Jonathan J Agar Barbara B Baker Shawn S Brennan Cindy C Pullenayegum Eleanor E

PloS one 20130625 6

<h4>Purpose</h4>To determine the feasibility of using the Ultrasound Cardiac Output Monitor (USCOM) as an adjunct during hemodynamic assessments by a pediatric medical emergency team (PMET).<h4>Methods</h4>Pediatric in-patients at McMaster Children's Hospital aged under 18 years requiring urgent PMET consultation, were eligible. Patients with known cardiac outflow valve defects, Pediatric Critical Care Unit in-patients, and those in cardiorespiratory arrest, were excluded. The primary outcome wa ...[more]

PMID: 23825593

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Dataset Information

Urgent ultrasound guided hemodynamic assessments by a pediatric medical emergency team: a pilot study.

Purpose

Methods

Results

Conclusion

Publications

Urgent ultrasound guided hemodynamic assessments by a pediatric medical emergency team: a pilot study.

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