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.