What question did this study set out to answer?

To assess the diagnostic accuracy of bedside limited echocardiography performed by emergency physicians in evaluating left ventricular function and inferior vena cava volume in critically ill pediatric patients.

November 16, 2004PEDIATRICS

Bedside Limited Echocardiography by the Emergency Physician Is Accurate During Evaluation of the Critically Ill Patient

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Why the study?

Does bedside limited echocardiography by the emergency physician accurately estimate left ventricular function and inferior vena cava volume compared to formal echocardiography in critically ill children?

Population

31 critically ill or injured children admitted to the intensive care unit, mean age 5.1 years, 48.4% girls…

Comparison

Bedside limited echocardiography by the… vs Independent formal echocardiogram by an…

Design

Cohort, Independent blinded pediatric cardiologist reviewed all images for…

Authors

JPJay PershadChildren's National SMSharon L. MyersUniversity of California, Davis CPCindy PloumanChildren's Medical Center

Discussion

Member takes

Implication

Hypothesis-generating for EP bedside echo in critically ill children; prospective outcome studies needed before practice change.

Key Points

To assess the diagnostic accuracy of bedside limited echocardiography performed by emergency physicians in evaluating left ventricular function and inferior vena cava volume in critically ill pediatric patients.
Prospective observational study evaluating a convenience sample of N=31 patients admitted to a pediatric intensive care unit (mean age 5.1 years; 58.1% receiving mechanical ventilation).
Emergency physicians performed bedside limited echocardiography to determine shortening fraction via parasternal short-axis M-mode imaging and maximal inferior vena cava diameter, followed by independent formal scans by experienced pediatric echocardiography providers.
An independent, blinded pediatric cardiologist evaluated all acquired ultrasound images for overall quality and measurement accuracy.
Shortening fraction estimates showed strong agreement between emergency physicians and pediatric echocardiography providers (r = 0.78), with a statistically significant mean difference of 4.4% (95% CI: 1.6% to 7.2%).
Inferior vena cava diameter estimates demonstrated high correlation between providers (r = 0.8), with a mean difference of 0.068 mm (95% CI: -0.16 to 0.025 mm) that was not statistically significant.

Structured PICO

Population

31 critically ill or injured children admitted to the intensive care unit, mean age 5.1 years, 48.4% girls, 58.1% on mechanical ventilatory support.

Intervention

Bedside limited echocardiography by the emergency physician (BLEEP)

Comparator

Independent formal echocardiogram by an experienced pediatric echocardiography provider (PEP)

Outcome

Accuracy in estimation of left ventricular function (LVF) via shortening fraction (SF) and inferior vena cava (IVC) volume via maximal diametersurrogate

Bedside limited echocardiography performed by emergency physicians shows good agreement with formal echocardiography for assessing left ventricular function and IVC volume in critically ill children.

Cite This Study

Pershad et al. (2004) studied this question.

synapsesocial.com/papers/6a7d277c166e996abdd5a4dd https://doi.org/10.1542/peds.2004-0881

Topics

Echocardiography

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Bedside Limited Echocardiography by the Emergency Physician Is Accurate During Evaluation of the Critically Ill Patient

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Bedside Limited Echocardiography by the Emergency Physician Is Accurate During Evaluation of the Critically Ill Patient

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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