Impact of Bedside Echocardiography in the Management of Critically Ill Pediatric Patients in the Pediatric Intensive Care Unit: A Cross-Sectional Study

床旁超声心动图在儿科重症监护病房危重患儿管理中的作用:一项横断面研究

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Abstract

Background Managing critically ill pediatric patients is a challenging responsibility that necessitates effective prioritization and time management. It is important not only to assess the condition of the patient on a continuous and real-time basis but also to assess in a way that will provide vital clues that may help in diagnosis and treatment. Our study aims to investigate the association between echocardiography and clinical systemic examination, to find the association between cardiac dysfunction and pediatric outcomes, and to identify the indications and necessity of echocardiography assessments and therapeutic interventions for patients in the pediatric intensive care unit. Methods This cross-sectional study was conducted in the pediatric intensive care unit (PICU) of the pediatrics department at Datta Meghe Institute of Higher Education and Research, Wardha, India. All critically ill pediatric patients admitted to the PICU underwent echocardiography. The study primarily focused on the indications for echocardiography, the association between systolic and diastolic dysfunction and patient outcomes, and the therapeutic interventions implemented based on the echocardiographic findings.  Results The study analyzed 139 subjects aged from one month to 204 months, with the majority in the one- to five-year age group, followed by the 10-15-year age group. Cardiac anomalies were identified in 39 out of 139 cases, and cardiac murmurs were present in 27 cases with an almost equal gender distribution in the infantile age group. Dyspnea, edema, and hepatomegaly were the most common indications for echocardiography. Lasix was the most commonly used antifailure drug used in heart diseases. Sixteen individuals had systolic dysfunction, and eight had diastolic dysfunction, with a mortality rate of 62%. There was a significant association between systolic and diastolic dysfunction and mortality. Conclusion Echocardiography is a valuable asset within the PICU, providing critical insights into cardiac function and hemodynamics. By guiding clinical decision-making, it plays a pivotal role in optimizing care strategies, ultimately leading to improved outcomes for pediatric patients admitted with cardiac conditions. Overall, the study emphasizes the complex nature of pediatric cardiac conditions and the necessity for individualized treatment approaches based on distinct diagnoses and clinical indications.

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